Ustinova Ksenia I, Langenderfer Joseph E
Department of Physical Therapy Central Michigan University, Mount Pleasant, Michigan, USA.
School of Engineering and Technology Central Michigan University, Mount Pleasant, Michigan, USA.
Rehabil Res Pract. 2024 Sep 11;2024:2751643. doi: 10.1155/2024/2751643. eCollection 2024.
The purpose of this quasiexperimental study was to test the effects of wearing the NewGait rehabilitative device on walking abilities in individuals with foot drop. The study involved 16 participants with foot drops caused by stroke (11 participants), multiple sclerosis (one participant), and peripheral neuropathies (four individuals). During a single testing session, participants walked 12 m at their self-selected speed in four experimental conditions: walking without any orthotic device; walking while wearing a regular plastic posterior leaf ankle foot orthosis (AFO); walking with the NewGait device assisting ankle dorsiflexion only; and walking with the NewGait device assisting the hip, knee, and ankle joint motions. Body motions during walking were recorded using a 3D system for motion analysis and analyzed with a set of spatiotemporal and kinematic parameters and a gait decomposition index. The gait decomposition index indicated sagittal interjoint coordination in the three joint pairs (hip-knee, knee-ankle, and hip-ankle) of the paretic (foot drop) leg during walking and was validated in a previous study. Overall, wearing all three orthotic devices improved the gait velocity, ankle dorsiflexion, and foot clearance compared to gait trials in which no assistive devices were used. However, wearing the AFO significantly restricted the plantarflexion range of motion and decreased interjoint coordination as measured by joint decomposition. In contrast, the NewGait device altered the ankle plantarflexion motions but also increased coordinated movement (reduced the decomposition) in most lower-extremity joint pairs and conditions. Therefore, the NewGait rehabilitative device can be considered superior to a regular AFO in correcting gait deviations caused by foot drop.
这项准实验研究的目的是测试佩戴NewGait康复设备对足下垂患者步行能力的影响。该研究纳入了16名因中风（11名参与者）、多发性硬化症（1名参与者）和周围神经病变（4名个体）导致足下垂的患者。在一次测试过程中，参与者在四种实验条件下以自我选择的速度行走12米：不佩戴任何矫形器械行走；佩戴常规塑料后叶踝足矫形器（AFO）行走；仅使用NewGait设备辅助踝关节背屈行走；使用NewGait设备辅助髋、膝和踝关节运动行走。行走过程中的身体运动通过三维运动分析系统进行记录，并使用一组时空和运动学参数以及步态分解指数进行分析。步态分解指数表明了患侧（足下垂）腿在行走过程中三个关节对（髋-膝、膝-踝和髋-踝）的矢状面关节间协调性，并且在之前的一项研究中得到了验证。总体而言，与未使用辅助器械的步态试验相比，佩戴所有三种矫形器械均提高了步速、踝关节背屈和足离地高度。然而，佩戴AFO显著限制了跖屈活动范围，并降低了通过关节分解测量的关节间协调性。相比之下，NewGait设备改变了踝关节跖屈运动，但也增加了大多数下肢关节对和条件下的协调性运动（减少了分解）。因此，在纠正由足下垂引起的步态偏差方面，NewGait康复设备可被认为优于常规AFO。
