Hesse S, Luecke D, Jahnke M T, Mauritz K H
Klinik Berlin, Department of Neurological Rehabilitation, Free University Berlin, Germany.
Int J Rehabil Res. 1996 Jun;19(2):133-41. doi: 10.1097/00004356-199606000-00004.
The purpose of the study was to investigate the effect of firm shoes and a particular type of a frequently prescribed ankle-foot orthosis in Germany, the Valens calliper, on functional gait parameters in hemiparetic patients with marked extensor spasticity and corresponding heel-strike problems. Cycle times, vertical ground reaction forces, trajectories of the centre of pressure (gait line) under the soles and the mode of initial contact were assessed in 19 hemiparetic patients walking barefoot, with firm shoes and the orthosis. With the shoes, significant improvements (p < 0.006) were observed for: walking velocity, stride length, initial double stance duration and gait line of the non-affected foot. The pattern of the vertical force diagram improved qualitatively in six patients. With the orthosis the following variables showed an even more marked improvement (p < 0.006): walking velocity, cadence, stride length, and gait line of both the affected and non-affected foot. Fourteen patients became rear-foot strikers and the vertical force pattern further improved in six patients. It is concluded that the ankle-foot orthosis (more than the shoes) provide a useful support in the early rehabilitation of hemiparetic patients with marked spasticity.
本研究的目的是调查德国一种常用的硬底鞋和一种特定类型的踝足矫形器（瓦伦斯夹）对患有明显伸肌痉挛和相应足跟撞击问题的偏瘫患者功能步态参数的影响。对19名偏瘫患者在赤脚、穿硬底鞋和佩戴矫形器行走时的周期时间、垂直地面反作用力、鞋底压力中心轨迹（步态线）和初始接触方式进行了评估。穿硬底鞋时，观察到以下方面有显著改善（p < 0.006）：行走速度、步幅、初始双支撑持续时间和非患侧脚的步态线。6名患者垂直力图的模式在质量上有所改善。佩戴矫形器时，以下变量有更显著的改善（p < 0.006）：行走速度、步频、步幅以及患侧和非患侧脚的步态线。14名患者变成了后足着地者，6名患者的垂直力模式进一步改善。结论是，踝足矫形器（比鞋子更有效）在患有明显痉挛的偏瘫患者的早期康复中提供了有益的支持。
