Association between improved trunk stability and walking capacity using ankle-foot orthosis in hemiparetic patients with stroke: evidence from three-dimensional gait analysis

Chin Med J (Engl). 2013 Oct;126(20):3869-73.

Abstract

Background: Restoration of both normal movement of the pelvis and centre of mass is a primary goal of walking rehabilitation in post-stroke patients because these movements are essential components of effective gait. The aim of this study is to quantitatively analyze the effect of ankle-foot orthosis on walking ability, and to investigate the correlation between improvements in trunk motion and walking capacity.

Methods: Walking speed, centre of mass displacement, and pelvic movements were examined in 20 post-stroke hemiparetic patients with and without ankle-foot orthosis using three-dimensional motion analysis.

Results: Using ankle-foot orthosis improved walking speed, pelvic rotation and tilt, and lateral and vertical displacements of the centre of mass (P < 0.01). Moreover, the gait asymmetry index was significantly decreased (P < 0.01), and the Functional Ambulation Categories score improved significantly when patients used an ankle-foot orthosis (P < 0.05). There was significant correlation between improvements in the walking capacity and the displacement of the centre of mass in both vertical and lateral directions (P < 0.01).

Conclusions: Using ankle-foot orthosis improves the walking capacity by improving the stability and concordant of the trunk in hemiplegic patients. The improvement in the walking capacity from using an ankle-foot orthosis may be attributed to its prevention of foot drop and compensation for the instability of the ankle joint.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Ankle / physiology
  • Ankle / physiopathology
  • Ankle Joint / physiology
  • Ankle Joint / physiopathology
  • Female
  • Foot Orthoses
  • Gait / physiology*
  • Humans
  • Male
  • Middle Aged
  • Stroke / physiopathology*
  • Walking / physiology*