Murayama Minoru
Niigata University of Health and Welfare, Niigata, Niigata, Japan.
Funabashi Municipal Rehabilitation Hospital, Funabashi, Chiba, Japan.
Jpn J Compr Rehabil Sci. 2021 Aug 27;12:32-37. doi: 10.11336/jjcrs.12.32. eCollection 2021.
Murayama M. Effectiveness of a knee-ankle-foot orthosis with a knee extension aid in gait training for stroke patients. Jpn J Compr Rehabil Sci 2021; 12: 32-37.
To evaluate the effectiveness of a knee-ankle-foot orthosis (KAFO) with a newly developed knee extension aid in gait training for stroke patients with severe leg paralysis.
The participants were 7 recovering stroke patients prescribed a KAFO. With the KAFO knee joint set to allow free flexion, knee flexion angle, lower limb muscle activity, and time of plantar ground contact were measured during assisted walking with the knee extension aid or a conventional support loop.
When first using the knee extension aid, knee flexion angle at initial ground contact was significantly decreased and time from heel strike on the paralyzed side to forefoot strike was prolonged compared with the support loop. After using the knee extension aid for 1 week, in addition to the two parameters above, maximum knee flexion angle during the swing phase, knee extension displacement from the maximum flexion angle to initial ground contact, and the muscle activity ratio of the biceps femoris during the swing phase were significantly increased compared with the support loop.
This knee extension aid may be indicated for patients who have difficulty in initial heel strike due to excessive knee flexion at the end of the swing phase.
村山正。带膝关节伸展辅助装置的膝-踝-足矫形器在脑卒中患者步态训练中的有效性。日本综合康复科学杂志2021年;12: 32 - 37。
评估一种带有新开发的膝关节伸展辅助装置的膝-踝-足矫形器(KAFO)在重度腿部瘫痪的脑卒中患者步态训练中的有效性。
参与者为7名正在康复的脑卒中患者,他们被开具了KAFO。将KAFO膝关节设置为允许自由屈曲,在使用膝关节伸展辅助装置或传统支撑环进行辅助步行时,测量膝关节屈曲角度、下肢肌肉活动以及足底与地面接触时间。
首次使用膝关节伸展辅助装置时,与支撑环相比,初始地面接触时的膝关节屈曲角度显著减小,瘫痪侧从足跟触地到前脚掌触地的时间延长。使用膝关节伸展辅助装置1周后,除上述两个参数外,与支撑环相比,摆动期的最大膝关节屈曲角度以及从最大屈曲角度到初始地面接触的膝关节伸展位移,还有摆动期股二头肌的肌肉活动比率均显著增加。
这种膝关节伸展辅助装置可能适用于因摆动期末膝关节过度屈曲而在初始足跟触地时存在困难的患者。