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KMID : 0361420130370040516
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Journal of Korean Academy of Rehabilitation Medicine
2013 Volume.37 No. 4 p.516 ~ p.522
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Effects on Foot External Rotation of the Modified Ankle-Foot Orthosis on Post-Stroke Hemiparetic Gait
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Kim Ha-Jeong
Chun Min-Ho
Kim Hong-Min
Kim Bo-Ryun
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Abstract
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Objective: To evaluate the effects of heel-opened ankle foot orthosis (HOAFO) on hemiparetic gait after stroke, especially on external foot rotation, and to compare the effects of HOAFO with conventional plastic-AFO (pAFO) and barefoot during gait. Methods: This cross-over observational study involved 15 hemiparetic patients with external rotation of the affected foot. All subjects were able to walk independently, regardless of their usual use of a single cane, and had a less than fair-grade in ankle dorsiflexion power. Each patient was asked to walk in three conditions with randomized sequences: 1) barefoot, 2) with a pAFO, and 3) with an HOAFO. Their gait patterns were analyzed using a motion analysis system. Results: Fifteen patients consisted of nine males and six females. On gait analysis, hip and foot external rotation were significantly greater in pAFO (-3.35o and -23.68o) than in barefoot and HOAFO conditions (p<0.05). Wearing an HOAFO resulted in significant decreases in hip (0.78o, p=0.04) and foot (-17.99o, p<0.01) external rotation compared with pAFO; although there was no significant difference between HOAFO and barefoot walking. Walking speed and percentage of single limb support were significantly greater for HOAFO than in barefoot walking. Conclusion: HOAFO was superior to pAFO in reducing hip and foot external rotation during the stance phase in patients with post-stroke hemiparesis. HOAFO may, therefore, be useful in patients with excessive external rotation of the foot during conventional pAFO.
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KEYWORD
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Ankle-foot orthosis, Foot rotation, Gait, Stroke
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