Kessler Foundation Research Center, West Orange, NJ, USA.
NeuroRehabilitation. 2010;27(4):343-50. doi: 10.3233/NRE-2010-0618.
This investigation utilized a single case design to evaluate the effects of a dynamic AFO on ambulation in post stroke hemiplegia. A single patient with stroke related hemiplegia using a dynamic AFO underwent gait analysis while walking on level ground. Outcome measures included temporal-spatial gait parameters and bilateral kinematic joint angles at the ankle, knee, and hip with and without AFO. Walking speed, stride length, step length and cadence increased with the dynamic AFO. Step width and double support decreased, while single support remained unchanged on the affected limb with the dynamic AFO. With the dynamic AFO there was increased hip flexion at foot strike and toe-off, increased hip sagittal plane angular velocity during swing, and decreased abduction. The dynamic AFO had a positive effect on the participant's overall gait which included improved temporal-spatial parameters and gait velocity which is likely due to a decrease in the overall energy cost of walking. Kinematic angles at the hip were most notably affected by brace utilization and this effect should be more fully explored. Further research with a larger sample utilizing dynamic AFOs is indicated to explore the generalizability of these findings and to determine the potential utility of these braces as an alternative to the traditionally prescribed solid AFO.
本研究采用单病例设计，评估动态踝足矫形器（AFO）对脑卒中后偏瘫患者步行的影响。一位脑卒中偏瘫患者使用动态 AFO 进行步态分析，在水平地面上行走。评估指标包括时空步态参数以及双侧踝关节、膝关节和髋关节的运动学关节角度，有无 AFO 时分别进行评估。使用动态 AFO 后，行走速度、步长、步长和步频增加。步宽和双支撑相减少，而在患侧，单支撑相保持不变。在使用动态 AFO 时，足跟着地和足趾离地时髋关节屈曲增加，摆动时髋关节矢状面角速度增加，外展减少。动态 AFO 对患者整体步态有积极影响，包括改善时空参数和步行速度，这可能是由于行走的整体能量消耗降低。髋部运动学角度受支具使用的影响最大，应进一步充分探讨这一影响。需要进一步进行更大样本的研究，使用动态 AFO 来探索这些发现的普遍性，并确定这些支具作为传统固定 AFO 的替代方案的潜在效用。
