Objective Our objective is to compare the immediate effects of ankle talus-stabilizing taping with those of barefoot and conventional ankle-foot orthosis on balance and gait parameters in patients with chronic stroke.

Background: Stroke is currently the leading cause of long-term disability because of the sequelae experienced by patients with stroke, which further impairs lower limb function and thus influences walking. There are many training approaches for improving balance and gait performance through reducing the ankle plantar flexor passive resistance using assistive treatment methods, such as robotic devices, functional electric stimulation, ankle-foot orthoses, and ankle mobilization with movement.Talus-stabilizing taping can be used to improve ankle range of motion and gait performance because it provides a posterior-inferior talar glide in a closed-chain dorsiflexion position. No previous studies have investigated the usefulness of  talus-stabilizing taping  in patients with chronic stroke. Recent studies reported that talus-stabilizing taping improves ankle range of motion and gait performance because talus-stabilizing taping provides a posterior-inferior talar glide in a closed-chain dorsiflexion position 

Hypothesize : We hypothesized that talus-stabilizing taping  would improve static balance ability, timed up and go test, gait parameters in the patients with chronic stroke. 

Plan : The order of conditions (talus-stabilizing taping , barefoot, and conventional ankle-foot orthosis) was determined using the web randomization site, and each patient performed the tests under the three conditions in random order to avoid bias through learning or fatigue. An experienced physical therapist was blinded to the patient intervention assignments and study hypotheses, limiting the potential for expectation bias. The patient characteristics and all outcome (static balance ability, timed up and go test, and gait parameters) measures were assessed by the same physical therapist. The measurements were repeated three times, and the mean value was calculated. 

Treatment

The order of conditions (talus-stabilizing taping, barefoot, and conventional ankle-foot orthosis (S, M, L size)) was determined using the web randomization site, and each patient performed the tests under the three conditions in random order.
The patient characteristics and all outcome (static balance ability, timed up and go test, and gait parameters) measures were assessed by the physical therapist.

Arm Label

Target Number of Participant

Arm Type

Arm Description

The order of conditions (TST, barefoot, and conventional AFO) was determined using the web randomization site, http://www.randomization.com, and each patient performed the tests under the three conditions in random order. 
1) For the talus-stabilizing taping, the patients placed the affected side ankle on the chair and advanced the tibia over the foot via knee flexion. An experienced physical therapist used protective under-tapes. A rigid strapping tape (37 mm width, Mueller M tape) was applied from the talus of the affected side ankle (passing below the medial and lateral malleolus) to the plantar surface of the calcaneus through the medial and lateral sides of the talus using maximal force with the tape.
2) The conventional ankle-foot orthosis used in this study was a standard, off-the-shelf, posterior leaf type, with a setting in neutral position. The orthosis came in three different sizes, and the one that best fitted each patient was used.
3) Measurements were made with bare feet. 

Gender

Age

Description

(1) diagnosis of hemiplegia due to hemorrhagic or ischemic stroke; more than 6 months post-stroke to minimize the effects of natural recovery; 
(2) independent gait possible over 10 m without assistive devices
(3) minimum score of 24 on the Korean Mini-Mental State Examination 
(4) spasticity in a lower affected side ankle (Modified Ashworth scale≤1)
(5) no orthopedic problems involving the lower extremities that would affect gait.

(1) medical problems other than neurological lesions that affected the gait patterns
(2) bilateral affected limbs
(3) premorbid or current orthopedic problem involving the lower extremities.

static balance ability

The patients performed the tests for 10 min to familiarize themselves with the three conditions until a proper motion in walking was achieved at a comfortable speed. A 5-min resting period was allowed after the familiarization period and before the data collection began. 

Timed up and go test

The patients performed the tests for 10 min to familiarize themselves with the three conditions until a proper motion in walking was achieved at a comfortable speed. A 5-min resting period was allowed after the familiarization period and before the data collection began. 

gait parameters

The patients performed the tests for 10 min to familiarize themselves with the three conditions until a proper motion in walking was achieved at a comfortable speed. A 5-min resting period was allowed after the familiarization period and before the data collection began