Study of gait rehabilitation of hemiplegic patients in early stage of rehabilitation using ankle-foot-orthoses

在偏瘫患者康复早期进行步态训练是十分重要的。在这个阶段，矫形辅助在步态中是必不可少的，并且afo的功能可根据每个患者的情况进行调节是可取的。然而，没有一种AFO的功能可以轻易改变。本研究旨在探讨急性偏瘫患者的afo功能。开发了一种试验AFO，并将其用于急性偏瘫患者的步态训练。试验AFO由一个产生辅助力矩的弹簧组成。试验AFO的踝关节活动范围和背屈辅助力矩的大小可以很容易地改变。采用三维步态分析系统（VICON512）和力板对AFO步态进行测量。结果发现，急性偏瘫患者所需辅助力矩的大小远小于慢性偏瘫患者。同时还发现辅助弹簧的斥力有时对急性偏瘫步态是有害的。在此基础上，对急性偏瘫患者步态训练所需的AFO规格进行了讨论。油阻尼器对跖屈曲产生反作用力而不产生反作用力，是急性偏瘫患者AFO辅助装置的第二种可能。带油阻尼器的AFO是未来的发展方向。

Gait training at the early stage of rehabilitation is quite important for hemiplegic patients. Orthotic assist during gait is indispensable at this stage and the adjustability of functions of AFOs to the condition of each patient is desirable. However, there is no AFO whose function can be changed easily. The purpose of this study is to investigate the function of AFOs for acute hemiplegic patients.A trial AFO was developed and used for the gait training of acute hemiplegic patients. The trial AFO consisted of a spring that produced the assist moment. The range of motion of the ankle joint and magnitude of the dorsiflexion assist moment of the trial AFO could be changed easily. The gaits with AFO were measured by three dimensional gait analysis system (VICON512) and force plates. As results, it was found that the magnitude of assist moment necessary for acute hemiplegic patients was much smaller than for chronic patients. And it was also found that the repulse force of the assist spring was sometimes harmful for acute hemiplegic gait. Based on these results the desirable specification of an AFO for gait training of acute hemiplegic patients was discussed. Oil damper which generates the reaction force to plantarflexion but does not generate the repulse force is second possibility for the assist device of the AFO for acute hemiplegic patients. An AFO with oil damper will be developed in the future.