Effects of ankle foot orthosis in stiff knee gait in adults with hemiplegia
Effects of ankle foot orthosis in stiff knee gait in adults with hemiplegia
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DOI：
10.1016/j.jbiomech.2012.08.015
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发表时间：
2012-10-11
影响因子：
2.4
通讯作者：
Emilio Olmos, Lisandro
中科院分区：
文献类型：
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作者：
Andres Gatti, Marcelo;Freixes, Orestes;Emilio Olmos, Lisandro
与健康受试者相比，中风患者的步态效率较低，这是因为在步态的摆动阶段，膝关节的异常屈曲，与股直肌痉挛和踝屈肌过度活动有关。了解踝足矫形器(AFO)对踝屈肌痉挛患者步态的影响是有意义的。这项研究的目的是比较AFO/鞋组合和赤足在卒中后踝屈肌痉挛患者中的膝关节运动学。在截瘫肢体的摆动阶段，评估了两个运动学变量：脚趾处膝关节屈曲角度和膝关节最大屈曲角度。我们还分析了非偏瘫肢体的步速和步长。所有变量在戴矫形器和不戴矫形器的情况下获得。使用运动捕捉系统(ELITE)获取运动学数据。佩戴AFO的受试者在步态速度(0.62m/S(0.08SD)比0.47m/S(0.13SD)(p=0.007))、非瘫痪肢体的步长(42 cm(5.9SD)比33.5 cm(6.6SD)(p=0.005))以及摆动阶段的最大膝关节屈曲角度：30.7度(14.1 SD)比26.3度(11.7SD)p=0.005。在没有AFO和AFO的情况下，膝关节屈曲角度没有显著差异。我们描述了AFO/鞋在轻中度中风后偏瘫受试者的膝关节运动学、非瘫痪肢体的步长和步态速度方面的好处。我们的结论是，使用AFO可以改善这些受试者的步态模式，提高速度。(C)2012爱思唯尔有限公司。保留所有权利。
Stroke survivors present a less efficient gait compared to healthy subjects due to abnormal knee flexion during the swing phase of gait, associated with spasticity of the rectus femoris muscle and overactivity of the ankle plantarflexors. It is relevant to understand the effect of the ankle foot orthosis (AFO) on gait in individuals with plantarflexor spasticity. The aim of this study was to compare the knee kinematics with an AFO/footwear combination and barefoot in post-stroke subjects with plantarflexor spasticity.Ten subjects with chronic hemiplegia were measured. Two kinematic variables were assessed during the swing phase of the paretic limb: knee flexion angle at toeoff and peak knee flexion angle. We also analyzed gait speed and step length of the non-paretic limb. All variables were obtained with and without the orthosis. Kinematic data were acquired using a motion capture system (ELITE). Subjects wearing an AFO showed significant improvements in gait speed (0.62 m/s (0.08 SD) vs. 0.47 m/s (0.13 SD) (p=0.007)), step length of the non-paretic limb (42 cm (5.9 SD) vs. 33.5 cm (6.6 SD) (p=0.005)) and peak knee flexion angle during the swing phase: 30.7 degrees (14.1 degrees SD) vs. 26.3 degrees (11.7 degrees SD) p=0.005. No significant differences were obtained in the knee flexion angle at toeoff between no AFO and AFO conditions.We described benefits with AFO/footwear use in the kinematics of the knee, the step length of the non-paretic limb, and the gait velocity in hemiplegic subjects after mild to moderate stroke. We conclude that the use of an AFO can improve the gait pattern and increase velocity in these subjects. (C) 2012 Elsevier Ltd. All rights reserved.