Effects of ankle-foot orthosis on gait pattern and spatiotemporal indices during treadmill walking in hemiparetic stroke.

IF 1.5 4区 医学 Q3 REHABILITATION International Journal of Rehabilitation Research Pub Date : 2023-12-01 Epub Date: 2023-09-22 DOI:10.1097/MRR.0000000000000602
Kei Ohtsuka, Masahiko Mukaino, Junya Yamada, Matsuda Fumihiro, Hiroki Tanikawa, Kazuhiro Tsuchiyama, Toshio Teranishi, Eiichi Saitoh, Yohei Otaka
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Abstract

Ankle-foot orthosis (AFO) is known to correct abnormal gait patterns and improve walking stability and speed in patients with hemiparesis. To quantify these benefits in post-stroke gait, a three-dimensional motion analysis of gait pattern was conducted. Forty patients with hemiparesis were enrolled. A three-dimensional motion analysis system was used to analyze patients' treadmill walking with/without an AFO. Outcome measures were 12 abnormal gait indices (forefoot contact, knee extensor thrust, retropulsion of the hip, flexed-knee gait, medial whip in the stance phase, circumduction gait, hip hiking, insufficient knee flexion during the swing phase, excessive lateral shifting of the trunk, contralateral vaulting, excessive hip external rotation, and posterior pelvic tilt), calculated using kinematic data and spatiotemporal indices, and the symmetry index of double-stance and single-stance time and step length. Forefoot contact (without AFO vs. with AFO: 71.0 vs. 65.8, P < 0.001), circumduction gait (65.0 vs. 57.9, P < 0.001), and contralateral vaulting (78.2 vs. 72.2, P = 0.003) were significantly reduced, whereas excessive hip external rotation (53.7 vs. 62.8, P = 0.003) significantly increased during walking with an AFO. Hip hiking (77.1 vs. 71.7) showed marginal reduction with the use of AFO ( P = 0.096). The absolute symmetry index of double-stance time (21.9 vs. 16.1, P = 0.014) significantly decreased during walking with an AFO. AFO effectively mitigates abnormal gait patterns typical of hemiparetic gait. A 3D motion analysis system with clinically oriented indices can help assess intervention efficacy for gait abnormalities.

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踝足矫形器对偏瘫脑卒中平板行走步态模式和时空指标的影响。
踝足矫形器(AFO)可以纠正偏瘫患者的异常步态模式,提高行走稳定性和速度。为了量化中风后步态的这些益处,对步态模式进行了三维运动分析。入选了40名偏瘫患者。使用三维运动分析系统来分析患者在有/没有AFO的情况下在跑步机上行走的情况。结果测量为12项异常步态指标(前掌接触、膝关节伸肌推力、髋关节后冲、膝关节屈曲步态、站立阶段的内侧鞭状步态、回旋步态、髋关节抬高、摆动阶段的膝关节屈曲不足、躯干过度侧移、对侧跳跃、髋关节过度外旋和骨盆后倾),利用运动学数据和时空指标计算,以及双站和单站时间和步长的对称性指标。前脚接触(无AFO与有AFO相比:71.0 vs.65.8,P<0.001)、回旋步态(65.0 vs.57.9,P<001)和对侧跳马(78.2 vs.72.2,P=0.003)显著减少,而在有AFO的行走过程中,过度的髋关节外旋(53.7 vs.62.8,P=0.005)显著增加。髋关节徒步(77.1 vs.71.7)随着AFO的使用而略有减少(P=0.096)。在使用AFO的步行过程中,双站时间的绝对对称指数(21.9 vs.16.1,P=0.014)显著降低。AFO有效地缓解了典型的偏瘫步态的异常步态模式。具有临床导向指标的3D运动分析系统可以帮助评估步态异常的干预效果。
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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
88
审稿时长
6-12 weeks
期刊介绍: International Journal of Rehabilitation Research is a quarterly, peer-reviewed, interdisciplinary forum for the publication of research into functioning, disability and contextual factors experienced by persons of all ages in both developed and developing societies. The wealth of information offered makes the journal a valuable resource for researchers, practitioners, and administrators in such fields as rehabilitation medicine, outcome measurement nursing, social and vocational rehabilitation/case management, return to work, special education, social policy, social work and social welfare, sociology, psychology, psychiatry assistive technology and environmental factors/disability. Areas of interest include functioning and disablement throughout the life cycle; rehabilitation programmes for persons with physical, sensory, mental and developmental disabilities; measurement of functioning and disability; special education and vocational rehabilitation; equipment access and transportation; information technology; independent living; consumer, legal, economic and sociopolitical aspects of functioning, disability and contextual factors.
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