Carse Bruce, Bowers Roy, Meadows Barry C, Rowe Philip
The Biomedical Engineering Department, University of Strathclyde, Glasgow, UK
The Biomedical Engineering Department, University of Strathclyde, Glasgow, UK.
Prosthet Orthot Int. 2015 Dec;39(6):454-62. doi: 10.1177/0309364614538090. Epub 2014 Jun 17.
Ankle-foot orthoses are known to have a generally positive effect on gait in stroke, however the specifc type of AFO and the time point at which it is provided are highly variable in the currently available literature.
The objective was to determine the immediate spatiotemporal and kinematic effect of custom-made solid ankle-foot orthoses in early stroke rehabilitation, compared to shod walking.
Five male and three female participants were recruited to the study (n = 8), with a mean age of 57 (16) years who were 3.5 (3) weeks post-stroke. Each received a custom-made solid ankle-foot orthosis to a predefined set of design criteria and tuned using heel wedges to control the shank inclination angle during shod walking. Repeated spatiotemporal and three-dimensional gait measures were taken pre- and immediately post-intervention.
A pre-post-test experimental study.
With the solid ankle-foot orthosis, walking velocity increased from 0.22 (0.2) to 0.36 (0.3) m/s (p < 0.05), overall average step length increased from 0.28 (0.1) to 0.37 (0.1) m (p < 0.05), cadence increased from 45 (19) to 56 (19) steps/min (p < 0.05) and step length symmetry ratio increased from 0.65 (0.2) to 0.74 (0.2) (not significant). No clear changes were observed in the joint kinematics of the hip and knee.
In our small group of early stroke patients who were fitted with a solid ankle-foot orthosis, immediate significant improvements occurred in walking speed, step length and cadence, when compared to walking with shoes only.
This study provides evidence about the immediate effects of custom solid ankle-foot orthoses on gait of early stroke survivors. Ankle-foot orthosis design specifications are fully described for replication. This study suggests that observing global segment orientation may be more useful than joint angles when fitting and tuning ankle-foot orthoses for optimal ankle-foot orthosis/footwear alignment.
已知踝足矫形器对中风患者的步态通常有积极影响，然而，在目前可得的文献中，踝足矫形器的具体类型及其提供的时间点差异很大。
目的是确定与穿鞋行走相比，定制的固态踝足矫形器在中风早期康复中的即时时空和运动学效果。
招募了5名男性和3名女性参与者（n = 8），平均年龄57（16）岁，中风后3.5（3）周。每个人都根据一组预定义的设计标准获得了定制的固态踝足矫形器，并使用后跟楔块进行调整，以控制穿鞋行走时小腿的倾斜角度。在干预前和干预后立即进行重复的时空和三维步态测量。
一项前后测试的实验研究。
使用固态踝足矫形器时，步行速度从0.22（0.2）米/秒增加到0.36（0.3）米/秒（p < 0.05），总体平均步长从0.28（0.1）米增加到0.37（0.1）米（p < 0.05），步频从45（19）步/分钟增加到56（19）步/分钟（p < 0.05），步长对称比从0.65（0.2）增加到0.74（0.2）（无显著性差异）。髋部和膝部的关节运动学未观察到明显变化。
在我们这一小群佩戴固态踝足矫形器的早期中风患者中，与仅穿鞋行走相比，步行速度、步长和步频立即有显著改善。
本研究提供了关于定制固态踝足矫形器对早期中风幸存者步态即时影响的证据。全面描述了踝足矫形器的设计规格以便重复研究。本研究表明，在为实现最佳踝足矫形器/鞋类对线而装配和调整踝足矫形器时，观察整体节段方向可能比关节角度更有用。
