Jagadamma Kavi C, Owen Elaine, Coutts Fiona J, Herman Janet, Yirrell Jacqueline, Mercer Thomas H, Van Der Linden Mariëtta L
Department of Physiotherapy, Queen Margaret University, East Lothian, Edinburgh, UK.
Prosthet Orthot Int. 2010 Sep;34(3):270-6. doi: 10.3109/03093646.2010.503225.
The effects of tuning the AFO footwear combination (AFOFC) for an adult with post-stroke hemiplegia were investigated. Gait analysis and tuning were carried out using a Vicon 3D motion analysis system and two force plates. Tuning of the AFOFC was accomplished by gradually modifying its design over a number of gait trials, to achieve optimal (i.e., as close as possible to normal, within the capability of the patient) knee kinematics and alignment of the Ground Reaction Force vector (GRF) relative to the knee joint. Heel wedges and a stiff rocker were used to tune mid-stance and terminal stance, respectively. Temporal-spatial parameters and selected kinetic and kinematic variables were compared between the non-tuned AFOFC, the tuned AFOFC immediately after tuning, and the tuned AFOFC after three months. There were several changes after three months compared to the non-tuned AFOFC, including improvement in stride length and a reduction in knee hyperextension. A subjective reduction in knee pain and improvement in function were also reported. The feasibility and the lack of objective evidence of tuning AFOFCs as a part of a clinical service need to be addressed in future research.
研究了为一名中风后偏瘫成人调整踝足矫形器鞋类组合（AFOFC）的效果。使用Vicon 3D运动分析系统和两个测力台进行步态分析和调整。通过在多次步态试验中逐步修改AFOFC的设计来完成调整，以实现最佳的（即，在患者能力范围内尽可能接近正常）膝关节运动学以及地面反作用力矢量（GRF）相对于膝关节的对齐。分别使用足跟楔形垫和硬摇椅来调整支撑中期和支撑末期。比较了未调整的AFOFC、调整后立即的调整后AFOFC以及三个月后的调整后AFOFC之间的时空参数以及选定的动力学和运动学变量。与未调整的AFOFC相比，三个月后有多项变化，包括步幅增加和膝关节过度伸展减少。还报告了膝关节疼痛主观减轻和功能改善。作为临床服务一部分的AFOFC调整的可行性以及缺乏客观证据的问题需要在未来研究中加以解决。
