[논문]Effects of an Elastic AFO on the Walking Patterns of Foot-drop Patients with Stroke

Hwang, Young-In

doi:10.13066/kspm.2020.15.1.1

Effects of an Elastic AFO on the Walking Patterns of Foot-drop Patients with Stroke 원문보기

대한물리의학회지 = Journal of the korean society of physical medicine, v.15 no.1, 2020년, pp.1 - 9

Hwang, Young-In (Department of Physical Therapy, College of Life and Health Science, Hoseo University)

Abstract ▼ AI-Helper

PURPOSE: Many patients with stroke have difficulties in walking with foot-drop. Various types of ankle-foot orthoses (AFOs) have been developed, but their weight needs to be reduced with the assistance of the ankle dorsiflexor. Therefore, an elastic AFO (E-AFO) was devised that not only improves the stability and flexibility of the ankle but also assists with ankle dorsiflexion while walking. This study examined the effects of an E-AFO, on the walking patterns of foot-drop patients with stroke. METHODS: Fourteen patients walked with and without an E-AFO, and the gait parameters were assessed using the GAITRite system. The spatiotemporal data on the gait patterns of stroke patients with foot-drop were compared using paired t-tests; the level of statistical significance was set to α<.05. RESULTS: No significant differences were observed in the velocity (p=.066) and affecte+d step length (p=.980), but the affected and less-affected stance (p=.022, p=.002) and swing time (p=.012, p=.005) were significantly different. The E-AFO produced a significant difference in the less-affected step length (p=.032). CONCLUSION: The E-AFO has a significant effect on the walking patterns of individuals with foot-drop and stroke. The E-AFO could be a useful assistive device for gait training in stroke patients.

주제어

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문제 정의

Although it could not be effective in improving the step length of the affected limb, it could strongly increase the less-affected step length. This study demonstrated that E-AFO could be a useful assistive device for gait training in stroke patients.
In this study, an AFO was devised using an elastic loop (elastic AFO; E-AFO) that not only improves the stability and flexibility of the ankle but also assists with ankle dorsiflexion while walking. This study investigated the effects of the E-AFO on the walking patterns of foot-drop patients with stroke, as well as its usefulness as a gait-training tool in clinical settings.

제안 방법

This could help improve the E-AFO design and clinical applicability. In addition, this study did not measure the kinematic data and weight-bearing ratios of the less-affected and affected sides when wearing the E-AFO. In the future, however, it would be necessary to assess these variables according to the gait phase using 3D motion analysis and a force plate.
reported that the plastic AFO increased the gait stability, thereby increasing the step length for both limbs [27]. In their study, however, the participants used two types of AFO, namely a hinged AFO and a shoehorn brace, which demonstrated the dual effects of ankle mobility and stability. This suggests that the E-AFO could improve the ankle flexibility and stability in the affected limb, thereby increasing the step length of the less-affected limb further.
In this study, an AFO was devised using an elastic loop (elastic AFO; E-AFO) that not only improves the stability and flexibility of the ankle but also assists with ankle dorsiflexion while walking. This study investigated the effects of the E-AFO on the walking patterns of foot-drop patients with stroke, as well as its usefulness as a gait-training tool in clinical settings.
The participants were asked to walk on the gait mat twice during each test, the first twice while wearing the E-AFO on the affected limb and the last twice without it. A 5-min rest was allowed after walking under each condition.
The averages of the parameters on each test were assessed. The reason for the repeated measurements with and without E-AFO was to investigate the immediate effects of wearing the E-AFO on the walking pattern of the foot-drop patients while minimizing any learning effects.

대상 데이터

Fourteen stroke patients with foot-drop from I and J Hospital in Busan, South Korea volunteered to participate in this study. Among the 14 participants (10 males and four females), six had right hemiplegia, and eight had left hemiplegia. The sample size was similar to that reported in previous studies [17,18].
Fourteen stroke patients with foot-drop from I and J Hospital in Busan, South Korea volunteered to participate in this study. Among the 14 participants (10 males and four females), six had right hemiplegia, and eight had left hemiplegia.
A 5-min rest was allowed after walking under each condition. The patient was seated in a chair near the GAITRite System, and the walking mat was adjusted to a distance of 1 m from the patient. The participants were allowed to walk approximately 1~2 m to gain control of their movements and adjust to the E-AFO; the short distance walked minimized the learning effects.

이론/모형

A Shapiro-Wilk test was used for the normality test, and the normality of data was satisfied (α>.05).
This study was supported by the Academic Research Fund of Hoseo University, 2017 [2017-0064]. The author designed the E-AFO.

후속연구

Second, no other AFOs were evaluated. In future studies, it will be necessary to investigate whether the E-AFO can be applied to patients with a spinal cord injury, multiple sclerosis, peroneus nervous palsy, and other conditions, as well as to compare the gait patterns associated with use of the E-AFO versus other types of AFO. This could help improve the E-AFO design and clinical applicability.

참고문헌 (29)

Centers for Disease Control and Prevention (CDC). Use of a registry to improve acute stroke care in seven states 2005-2009. Morbidity and Mortality Weekly Report. 2011;60(7);206-10.
Woolley SM. Characteristics of gait in hemiplegia. Topics in Stroke Rehabilitation. 2001;7(4):1-18.

상세보기
Balaban B, Tok F, Yavuz F, et al. Early rehabilitation outcome in patients with middle cerebral artery stroke. Neuroscience Letters. 2011;498(3):204-7.

상세보기
Perry J, Garrett M, Gronley JK, et al. Classification of walking handicap in the stroke population. Stroke. 1995;26(6):982-9.

상세보기
Tok F, Balaban B, Yasar E, et al. The effects of on a botulinum toxin A injection into rectus femoris muscle in hemiplegic stroke patients with stiff-knee gait: a placebo-controlled, nonrandomized trial. American Journal of Physical Medicine Rehabilitation. 2012;91(4):321-6.

상세보기
Tok F, Ozcakar L, Safaz I, et al. Effects of botulinum toxin-A on the muscle architecture of stroke patients: the first ultrasonographic study. Journal of Rehabilitation Medicine. 2011;43(11):1016-9.

상세보기
Lajoie Y, Teasdale N, Cole J D, et al. Gait of a deafferented subject without large myelinated sensory fibers below the neck. Neurology. 1996;47(1):109-15.

상세보기
Burridge JH, Wood DE, Taylor PN, et al. Indices to describe different muscle activation patterns, identified during treadmill walking in people with spastic drop-foot. Medical Engineering & Physics. 2001;23(6):427-34.

상세보기
Perry J, Burnfield JM. Gait Analysis: Normal and Pathological Function. (2nd ed). Thorofare, NJ. Slack Incorporated. 2010.
Chu TT. Biomechanics of ankle-foot orthoses: past, present, and future. Topics in Stroke Rehabilitation. 2001;7(4):19-28.

상세보기
Simkin A, Robin GC, Magora A, et al. Investigation of gait. 6. Relationship between muscle action and mechanical stresses in below-knee braces. Electromyography and Clinical Neurophysiology. 1973;13(5):495-503.

상세보기
Magora A, Robin GC, Rozin R, et al. Investigation of gait. 5. Effect of a below-knee brace on the contralateral unbraced leg. Electromyography and Clinical Neurophysiology. 1973;13(3):355-61.

상세보기
Tropp H, Norlin R. Ankle performance after ankle fracture: a randomized study of early mobilization. Foot & Ankle International. 1995;16(2):79-83.

상세보기
Geboers JF, Van TuijI JH, Seelen HA, et al. Effect of immobilization on ankle dorsiflexion strength. Scandinavian Journal of Rehabilitation Medicine. 2000;32(2):66-71.

상세보기
Bobath B. Adult Hemiplegia: Evaluation and Treatment. London. Butterworth-Heinemann. 1990.
Kobayashi T, Singer ML, Orendurff MS, et al. The effect of changing plantarflexion resistive moment of an articulated ankle-foot orthosis on ankle and knee joint angles and moments while walking in patients post stroke, Clin. Biomech. 2015;30(8):775-80.

상세보기
Shin YJ, Lee JH, Choe YW, et al. Immediate effects of ankle eversion taping on gait ability of chronic stroke patients. J Bodyw Mov Ther. 2019;23(3):671-7.

상세보기
Hwang YI, Yoo WG, An DH, et al. The effect of an AFO-shaped elastic band on drop-foot gait in patients with central neurological lesions. NeuroRehabilitation. 2013;32(2):377-83.

상세보기
Webster KE, Wittwer JE, Feller JA. Validity of the GAITRite walkway system for the measurement of averaged and individual step parameters of gait. Gait Posture. 2005;22(4):317-21.

상세보기
van Bloemendaal M, Beelen A, Kleissen RFM, et al. Concurrent validity and reliability of a low-cost gait analysis system for assessment of spatiotemporal gait parameters. J Rehabil Med. 2019;51(6):456-63.
Longo MR, Azanon E, Haggard P. More than skin deep: body representation beyond primary somatosensory cortex, Neuropsychologia. 2010:48(3);655-68.

상세보기
Leung J, Moseley A. Impact of ankle-foot orthoses on gait and leg muscle activity in adults with hemiplegia: systematic literature review. Physiotherapy. 2003;89(1):39-55.

상세보기
Erel S, Uygur F, Engin Simsek I, et al. The effects of dynamic ankle-foot orthoses in chronic stroke patients at three-month follow-up: a randomized controlled trial. Clinical Rehabilitation. 2011;25(6):515-23.

상세보기
Gok H, Kucukdeveci A, Altinkaynak H, et al. Effects of ankle-foot orthoses on hemiparetic gait. Clinical Rehabilitation. 2003;17(2):137-9.

상세보기
Simons CD, van Asseldonk EH, van der Kooij H, et al. Ankle-foot orthoses in stroke: effects on functional balance, weight-bearing asymmetry and the contribution of each lower limb to balance control. Clinical Biomechanics (Bristol, Avon). 2009;24(9):769-75.

상세보기
Abe H, Michimata A, Sugawara K, et al. Improving gait stability in stroke hemiplegic patients with a plastic ankle-foot orthosis. The Tohoku Journal of Experimental Medicine. 2009;218(3):193-9.

상세보기
Nolan KJ, Yarossi M. Preservation of the first rocker is related to increases in gait speed in individuals with hemiplegia and AFO. Clinical Biomechanics (Bristol, Avon). 2011;26(6):655-60.

상세보기
Lewallen J, Miedaner J, Amyx S, et al. Effect of three styles of custom ankle-foot orthoses on the gait of stroke patients while walking on level and inclined surfaces. JPO Journal of Prosthetics and Orthotics. 2010;22(2):78-83.

상세보기
Tyson SF, Thornton HA. The effect of a hinged ankle-foot orthosis on hemiplegic gait: objective measures and users' opinions. Clinical Rehabilitation. 2011;15(1):53-8.

상세보기

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