Affiliation:
1. From the Klinik Berlin, Department Neurological Rehabilitation, Free University Berlin (Germany) (S.H., C.W., K.M.); Disablement Services Center, Addenbrookes Hospital NHS Trust, Cambridge, UK (K.S.); and Department of Physical Medicine and Rehabilitation, University of Bucharest (Romania) (M.B.).
Abstract
Background and Purpose
—This study investigated the non–velocity-related effects of a 1-bar rigid ankle-foot orthosis on the gait of hemiparetic subjects, with particular emphasis on the muscle activity of the paretic lower limb.
Methods
—Twenty-one hemiparetic subjects who had been using an ankle-foot orthosis for equinovarus deformity for <1 week participated. Patients walked cued by a metronome at a comparable speed with and without the orthosis. Dependent variables were basic, limb-dependent cycle parameters, gait symmetry, vertical ground reaction forces, sagittal ankle excursions, and kinesiological electromyogram of several lower limb muscles.
Results
—The use of the caliper was associated with more dynamic and balanced gait, characterized by longer relative single-stance duration of the paretic lower limb, better swing symmetry, better pivoting over the stationary paretic foot, and better ankle excursions (
P
<0.05). The functional activity of the paretic quadriceps muscles increased, while the activity of the paretic tibialis anterior muscle decreased (
P
<0.05).
Conclusions
—The orthosis led to a more dynamic and balanced gait, with enhanced functional activation of the hemiparetic vastus lateralis muscle. The study further supports the functional benefits of a rigid ankle-foot orthosis in hemiparetic subjects as an integral part of a comprehensive rehabilitation approach. However, the reduced activity in the tibialis muscle may lead to disuse atrophy and hence long-term dependence on the orthosis.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Clinical Neurology
Reference22 articles.
1. Perry J Montgomery J. Gait of the stroke patient and orthotic indications. In: Brandstater ME Basmajian JV eds. Stroke Rehabilitation. Baltimore Md: Williams & Wilkens; 1987:246–283.
2. CLINICAL TRIAL OF A LOW-TEMPERATURE PLASTIC ANTERIOR ANKLE FOOT ORTHOSIS
3. Gait function in spastic hemiparetic patients walking barefoot, with firm shoes, and with ankle-foot orthosis
Cited by
110 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献