The Effects of Shoe Lifts to the Unaffected Limb on Gait Pattern in Hemiplegic Stroke Patients

OBJECTIVE: To evaluate the effects of shoe lift to the unaffected limb on hemiplegic gait after stroke. METHOD: Three dimensional gait analysis was performed in 20 chronic hemiplegic patients with shoe lifts (5, 10, 15 mm) to the unaffected limb. The order of experimental series was randomized among subjects. Temporal gait parameters were measured and compared according to the height of shoe lifts in the affected and unaffected limbs. RESULTS: The stride time of both limbs and step time of the affected limb were decreased, and stride length of both limbs and step length of unaffected limb were increased after shoe lift apply (p<0.05). Thus walking velocity and cadence were increased. In gait cycle, there was decreased double limb support phase of affected limb (p<0.05). These improvement of gait patterns of hemiplegics was maximum after shoe lift of 10 mm height. CONCLUSION: Weight bearing with shoe lift may contribute to improved postural control and gait performance in hemiplegics. Furthermore, the study about long-term effects of shoe lifts to the unaffected limb may be necessary.

The Effect of Shoe Lift on Lumbar Scoliosis Associated with Pelvic Obliquity / 대한척추외과학회지

STUDY DESIGN: A retrospective study designed to evaluate the effect of a shoe lift on the lumbar scoliosis associated with pelvic obliquity. OBJECTIVES: To analyze the changes in pelvic height, Cobb angle and clinical manifestations after application of a shoe lift. SUMMARY OF LITERATURE REVIEW: The most common form of scoliosis in adolescence is idiopathic (85% of scoliosis), which is a form of structural scoliosis. Some non-structural scoliosis may be assessed as an idiopathic form, which can result in an unnecessary treatment, such as bracing. Pelvic obliquity may be a cause of non-structural scoliosis, and a shoe lift may be used for its correction. MATERIALS AND METHODS: Twelve cases of lumbar scoliosis associated with pelvic obliquity, between April, 1998 and October, 2002, were investigated for the changes in the pelvic height and Cobb angle. Standing T-L AP and standing pelvic AP for measuring the Cobb angle and pelvic obliquity, respectively, were checked before and after application of a shoe lift. The Bell-Thompson method was used for measuring the limb length discrepancy. The shoe lift was composed of a compact cork pad and soft sponge tissue. The extent of a shoe lift was determined with the use of the most comfortable wood block height on stand-ing still. The radiological and clinical outcomes of the shoe lift were investigated. RESULTS: After the introduction of the shoe lift, 9 cases (75%) achieved a leveled pelvis (height difference less than 0.3cm) 1 week post-shoe lift. The mean Cobb angle before treatment was 16degrees ranging from 9 to 26degrees which was reduced to 6.7degrees ranging from 0 to 23degrees due to the shoe lift 1 week post-shoe lift. The mean correction of the Cobb angle after the introduction of a shoe lift was 73.9%. Clinically, 2 cases with low back pain achieved an improvement in the pain, and most patients expressed that walk-ing and standing had become more comfortable. CONCLUSION: A shoe lift seems to be significantly effective in correcting the Cobb angle and pelvic height in lumbar scoliosis associated with pelvic obliquity.