Development of an Anterior Foot Drop Ankle Foot Orthosis with Adjustable Stiffness / 医用生物力学

Objective For patients with foot drop gait, to design a kind of anterior ankle foot orthosis (AFO) with adjustable stiffness, so as to restore natural gait of the ankle by limiting the patients’ unusual plantar flexion to the optimum extent. Methods The minimum orthodontic moment of 10 foot drop male patients was measured by self-made experimental equipment, which could be used to select optimum material modulus of the AFO. The relationship between elastic modulus and different filling structures and filling ratio parameters was studied by tensile test. A typical patient with foot drop was selected, and the anterior AFO fitting the shape of patient’s foot was quickly made by three-dimensional (3D) printing with foot geometric data and specific filling material, filling structure and filling rate. The kinematics and surface electromyography (sEMG) of plantar flexors were tested under barefoot and wearing two kinds of AFOs, so as to verify the effect of the AFO on plantar flexion. The effectiveness of the limitation and the degree of preservation of ankle valgus and plantar flexion were discussed. Results The minimum corrective torque required for 10 male patients with foot drop was 2.16 N·m. Compared with the rigid AFO, the range of motion (ROM) of plantar flexion and valgus increased by 67.8% and 88.6% respectively with the flexible AFO. The activation of the muscles responsible for plantar flexion (soleus, medial head of gastrocnemius and lateral head of gastrocnemius) also decreased by 38.3%, 46.6% and 55.8%. Conclusions This AFO with adjustable stiffness can be used for orthosis customization of patients with foot drop, providing more effective and long-term orthosis function and potential.

The effects of a half palm ankle-foot orthosis and a hollow-heel ankle-foot orthosis on the gait of stroke survivors / 中华物理医学与康复杂志

Objective:To observe any effect of a half palm ankle-foot orthosis and a hollow-heel ankle-foot orthosis on the gait of stroke survivors.Methods:The walking of twenty-five stroke survivors was quantified using a gait analysis system. They walked barefoot, wearing a half palm ankle-foot orthosis and wearing a hollow-heel ankle-foot orthosis. Walking speed, step frequency, duration of the swing phase on the healthy and affected sides, risk of falling and Timed Up and Go (TUG) test times were recorded and analyzed.Results:The average gait frequency when wearing the hollow-heel ankle-foot orthosis was significantly faster than that in the other two conditions. The gait asymmetry coefficient was significantly different when the subjects wore the hollow-heel ankle-foot orthosis compared with walking barefoot. Compared with being barefoot, the average TUG time was significantly shorter when wearing either orthosis and the risk of falling was significantly less. The fall risk was significantly lower when wearing the hollow-heel orthosis compared to the half palm orthosis.Conclusion:Wearing either ankle-foot orthosis can significantly correct the gait of stroke survivors and lower their risk of falling, with better effect when wearing the hollow-heel ankle-foot orthosis.

Effects of Knee-Ankle-Foot Orthosis with Knee Joint Capable of Knee Flexion Control on the Gait of Stroke Patients / The Japanese Journal of Rehabilitation Medicine

Objective：The knee joint in patients using a knee-ankle-foot orthosis (KAFO) is locked, and the lack of knee flexion can cause some problems in the gait, such as circumduction and excessive pelvic obliquity. Hence, a KAFO with knee flexion control was developed. This study aimed to compare the gait in stroke patients using KAFOs with a locked knee joint and a controlled knee joint.Methods：A newly developed electro-attractive-material (EAM) was used for the knee joint in the KAFO. The knee joint is locked in the stance phase, and released immediately after the manual switch is pushed by a physical therapist.The gait of seven stroke patients in the recovery phase was measured for KAFO with a locked knee joint (locked knee) and a controlled knee joint (EAM knee) . For gait measurement, an inertial sensor, a foot switch, and an EMG sensor were used.Results：The velocity increased and the swing time decreased in the EAM-knee as compared to the locked knee. The abduction, external rotation, and extension of the hip joint decreased in the EAM knee. Increased activity of the rectus femoris muscle in the loading response, and decreased activity of the longissimus doris in the swing phase were observed in the EAM knee.Conclusions：It was suggested that EAM KAFO could improve the gait parameter and reduce the movement on the paretic side by compensatory motions in the swing phase, thereby reducing the muscle activity of the longissimus doris muscle.

Effects of Knee-Ankle-Foot Orthosis with Knee Joint Capable of Knee Flexion Control on the Gait of Stroke Patients / The Japanese Journal of Rehabilitation Medicine

Objective：The knee joint in patients using a knee-ankle-foot orthosis (KAFO) is locked, and the lack of knee flexion can cause some problems in the gait, such as circumduction and excessive pelvic obliquity. Hence, a KAFO with knee flexion control was developed. This study aimed to compare the gait in stroke patients using KAFOs with a locked knee joint and a controlled knee joint.Methods：A newly developed electro-attractive-material (EAM) was used for the knee joint in the KAFO. The knee joint is locked in the stance phase, and released immediately after the manual switch is pushed by a physical therapist.The gait of seven stroke patients in the recovery phase was measured for KAFO with a locked knee joint (locked knee) and a controlled knee joint (EAM knee). For gait measurement, an inertial sensor, a foot switch, and an EMG sensor were used.Results：The velocity increased and the swing time decreased in the EAM-knee as compared to the locked knee. The abduction, external rotation, and extension of the hip joint decreased in the EAM knee. Increased activity of the rectus femoris muscle in the loading response, and decreased activity of the longissimus doris in the swing phase were observed in the EAM knee.Conclusions：It was suggested that EAM KAFO could improve the gait parameter and reduce the movement on the paretic side by compensatory motions in the swing phase, thereby reducing the muscle activity of the longissimus doris muscle.

Comparative study of anterior support ankle foot orthosis and posterior ankle foot orthosis in foot drop patients

Background: Anterior Support Ankle Foot Orthosis (A-AFO) is a fairly recent approach. There is dearth of studies relating to comparison of metabolic efficiency of A-AFO and P-AFO. Objective was to study the efficacy of A-AFO compared to P-AFO in foot drop patients, using gait and metabolic analysis.Methods: It was a cross over study, included foot drop patients who could walk with/ without orthosis. Patients having spasticity more than grade 2 (Modified Ashworth Scale) were excluded. The metabolic parameters measured were volume of Oxygen consumed at Standard Temperature and Pressure in l/min (VO2), Dry in l/min, Rate of Oxygen consumption (MET), Volume of Carbon dioxide produced in litre/min (VCO2). Along with various gait parameters, questionnaire about patient’s preference after 4 weeks was also incorporated.Results: A-AFO was significantly better than P-AFO in terms of VO2 and VCO2 (p value = 0.02 and 0.009 respectively) as well as in terms of subjective preference.Conclusions: A-AFO is comparable to P-AFO in terms of energy efficiency, gait parameters and subjective preference, hence should also be prescribed.

The effects of a short ankle-foot orthosis on gait in patients with post-stroke hemiplegia

@#Objective: We evaluated the effects of a short ankle-foot orthosis (AFO) in patients with post-stroke hemiplegia by comparing its effectiveness to that of a conventional solid plastic AFO. The calf shells of the long and short AFOs were manufactured in lengths that extended proximally 2.5 cm distal to the fibular head and mid-calf level, respectively. Methods: Ten patients with chronic hemiparetic stroke were recruited for the study. Two types of AFOs, short and long, were used, both of which were individually molded and fitted. AFO preference was evaluated using a questionnaire regarding AFO weight, ease of donning and doffing, stability, and comfort. AFO effectiveness was evaluated using gait analysis. Results: The short AFO improved gait speed, stride length, and toe clearance as effectively as the long AFO. Additionally, we found that the short AFO had additional merits in terms of its lighter weight and ease of donning and doffing. Conclusion: The short AFO is a useful treatment option, especially in patients who dislike the heaviness of conventional AFOs or who have difficulty donning and doffing conventional AFOs.

A novel hinged ankle foot orthosis for gait performance in chronic hemiplegic stroke survivors: a feasibility study

Stroke survivors with gait disturbances may use ankle foot orthoses (AFOs). However, most AFOs come in one-piece styles, which make it difficult for spasticity-affected stroke survivors to don. AFOs are also limited since they do not properly prevent ankle joint for foot drop by itself. Therefore, the present study developed a novel hinged AFO by adding a locking device to a hinged joint. We then tested its feasibility in 9 hemiplegic stroke survivors by investigating temporal–spatial gait parameters using the GAITRite in the following 3 conditions: no AFO, traditional AFO, and novel hinged AFO. There was no significant difference in spatiotemporal gait parameters among the different conditions. There were greater decreases in gait velocity, cadence, step length, and stride length in the novel hinged AFO group than in the no AFO and traditional AFO groups. This novel hinged AFO was developed to prevent foot drop. However, the AFO did not show significant differences in gait parameters because it consists of metal with extra weight and volume. Functionally, it prevented foot drop. It also improved convenience by its releasable design. Thus, further studies are needed to develop an AFO that improves gait and is convenient to use for hemiplegic stroke survivors.

Efficacy of acupuncture combined with computer-aided movable and measurable ankle-foot orthosis (CMM-AFO) on injury of nervus peroneus communis / 中国针灸

<p><b>OBJECTIVE</b>To observe the efficacy difference among medication, medication plus rehabilitation training and medication plus rehabilitation training plus acupuncture on injury of nervus peroneus communis.</p><p><b>METHODS</b>A total of 81 patients were randomly divided into a control group, an observation 1 group and an observation 2 group; three patients dropped out and 78 patients were included into statistical analysis, 26 patients in each group. The patients in the control group were treated with oral administration of mecobalamin, 500 μg per time, 3 times a day for 60 days. Based on the treatment of control group, the patients in the observation 1 group were treated with rehabilitation training by computer-aided movable and measurable ankle-foot orthosis (CMM-AFO). Based on the treatment of observation 1 group, the patients in the observation 2 group were treated with acupuncture at Jiexi (ST 41), Fenglong (ST 40), Yanglingquan (GB 34) and Zusanli (ST 36), etc, 30 min per treatment, once a day for 60 days. After 60-day treatment, the clinical efficacy was evaluated; the muscle strengths of foot dorsal stretch and digital flexion were evaluated; the motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) were recorded.</p><p><b>RESULTS</b>After treatment, 20 patients were cured in the observation 2 group, which was significantly higher than 8 patients in the control group and 15 patients in the observation 1 group (both <0.05). The muscle strengths, SCV and MCV in the observation 2 group were significantly higher than those in the control group and the observation 1 group (all <0.05).</p><p><b>CONCLUSION</b>Acupuncture combined with CMM-AFO have significant efficacy on injury of nervus peroneus communis, and improve muscle strengths, SCV and MCV, which are superior to medication alone and medication plus rehabilitation training.</p>

Application of Family- centered Care in Children with Spastic Cerebral Palsy Wearing Ankle-foot Orthosis / 中国康复理论与实践

@#Objective To investigate the effect of family-centered care on wearing ankle-foot orthosis (AFO) in children with spas-tic cerebral palsy. Methods From July to December, 2016, 65 children with spastic cerebral palsy were divided into control group (n=32) and observation group (n=33). The control group accepted routine nursing, while the observation group accepted family-centered care. The children were assessed with modified Ashworth Scale (MAS), and the incidence of skin and soft tissue problems, the compliance for wearing AFO and the satisfaction for nursing service were re-corded. Results The score of MAS decreased in the observation group compared with that in the control group (t=3.298, P=0.002), and the incidence of skin and soft tissue problems was less (χ2=7.386, P=0.007). The compliance of pa-tients wearing AFO for rehabilitation, the rate that family performed the rehabilitation, the satisfaction for nurs-ing service were all more in the observation group than in the control group (χ2>5.346, P<0.05). Conclusion The application of family-centered care can improve the compliance for wearing AFO in the children with spastic cerebral palsy, to improve the rehabilitation effect, reduce the incidence of complications, and promote the satisfaction for nursing service.

Orthotic insole combined with an ankle-foot orthosis improve the walking ability of hemiplegic patients more effectively than an ankle-foot orthosis alone / 中华物理医学与康复杂志

Objective To explore the effect on walking ability of the orthotic insole produced by the International College of Biomechanics (ICB) when it is combined with an ankle foot orthosis (AFO).Methods A total of 40 stroke survivors with hemiplegia were randomly divided into an observation group and a control group,each of 20.In addition to conventional medical treatment and rehabilitation,the control group received AFOs and walking rehabilitation training.The observation group accepted walking training with an ICB orthotic insole combined with an AFO.The experiment lasted 4 weeks.Timed up and go test (TUGT) times,10 m maximum walking speed (10 m MWS) and Berg balance scale (BBS) ratings were recorded before and after the treatment.Results Before the treatment there was no significant difference between the group averages in terms of any of the measures.After the treatment,significant improvement was observed in all of the measurements,with the improvements in the observation group significantly better than those in the control group,on average.Conclusion An ICB orthotic insole combined with an AFO results in better improvements in the walking ability of hemiplegic subjects than an AFO alone.

Benefits from using an ankle-foot orthosis in children with myelomeningocele / Benefícios do uso da órtese tornozelo-pé nas crianças com mielomeningocele

Myelomeningocele (MMC) or spina bifida is a defect of the neural tube in which the spinal cord, its envelopes (meninges), and vertebral arches develop abnormally in the beginning of gestation, and owing to this failure of closure there appear a series of congenital defects and associated comorbidies, impairing in several aspects the functioning of the life of children with MMC. The congenital clubfoot has been found the most common orthopaedic anomaly in patients with MMC. The ankle-foot orthosis (AFO) is an orthopaedic device commonly used by these children to minimize the sequelae caused by this anomaly. OBJECTIVE: Identify the functional benefits brought about by the use of the AFO to children with MMC, as reported by their guardians. METHOD: Descriptive, transversal study. Convenience sample consisting of 25 guardians of children with MMC who were using/had used an AFO. RESULTS: Eighty percent of the guardians have reported at least one benefit brought about by the use of the AFO, among them: improvement in foot position (68%), foot growth (40%), improvement in foot balance (32%), and balance sitting position (15%). CONCLUSION: The use of the AFO by children with MMC can provide several benefits reported by their guardians.

A mielomeningocele (MMC) ou espinha bífida é um defeito do tubo neura no qual a medula espinal, seus envoltórios (meninges) e os arcos vertebrais desenvolvem-se anormalmente no início da gestação e, como consequências, temos uma série de defeitos congênitos e comorbidades associadas prejudicando a funcionalidade em diversos aspectos da vida das crianças com MMC. O pé torto congênito foi apontado como a anomalia ortopédica mais comum nos pacientes com MMC e a órtese tornozelo-pé (OTP) é um aparelho ortopédico que pode ser usado nessas crianças para amenizar as sequelas geradas por essa anomalia. OBJETIVO: Identificar os benefícios funcionais trazidos pelo uso da OTP em crianças com MMC relata-dos pelos seus responsáveis. MÉTODO: Estudo descritivo, transversal. Amostra de conveniência composta por responsáveis de 25 crianças com MMC que usavam/usaram a OTP que responderam a uma entrevista estruturada que contemplava as variáveis estudadas. RESULTADOS: Oitenta por cento dos responsáveis relataram pelo menos um benefício causado pelo uso da OTP, dentre eles: melhorou a postura do pé (68%), o pé cresceu (40%), melhorou o equilíbrio em pé (32%), melhorou o equilíbrio sentado (15%). CONCLUSÃO: O uso da OTP em crianças com MMC pode proporcionar benefícios identificados pelos responsáveis.

Comparative study of the therapeutic effect of functional electrical stimulation and ankle-foot orthosis in improving walking function in stroke patients / 中华物理医学与康复杂志

Objective To compare the clinical therapeutic effect of functional electrical stimulation (FES) and ankle-foot orthosis (AFO) in improving walking function in stroke patients.Methods Thirty-six stroke patients satisfying the enrolling criterion of the research were randomly divided into two groups:FES group and AFO group (n =18 in each).Both groups received the same routine rehabilitation therapy and medical treatment.Patients of FES group received FES of common peroneal nerve and tibialis anterior muscle of the affected limb,30 min per day,5 days per week,4 weeks in total,while the patients of AFO group received walking training with AFO wearing on,30 min per day,5 days per week,4 weeks in total.Walking function was assessed by 10-meter maximum walking speed,timed-up and go test (TUGT),functional ambulation category(FAC),the muscle tension of ankle flexor and Brunnstrom stage,which were carried out before treatment and four weeks after treatment.Results Before treatment,there was no significant difference between the two groups for the baseline of measurement(P ＞ 0.05).After 4 weeks of treatment,10MWT,TUGT,FAC scores and Brunnstrom stages in the two groups significantly increased (P ＜ 0.05).The 10MWT,FAC scores and Brunnstrom stage increased more significantly in FES group than those in AFO group (P ＜ 0.05).There was no significant differences with regard to TUGT and the muscle tension of ankle flexor between the two groups (P ＞ 0.05).Conclusions Both FES and AFO can accelerate the recovery of walking function in hemiplegia patients.FES can improve the walking ability in patients with stroke more significantly.

The effect of botulinum toxin type A injection with ankle-foot orthosis on patients with post-stroke lower limb spasticity / 中华物理医学与康复杂志

Objective To investigate the efficacy of botulinum toxin type A injection with ankle-foot orthosis (AFO) for the treatment of post-stroke lower limb spasticity.Methods One hundred and three stroke patients with lower limb spasticity were randomly divided into control group,observation group and treatment group.The patients in control group were given routine treatment,those in observation group were given botulinum toxin type A injection in addition to routine treatment,and those in treatment group were treated with AFO on the basis of the interventions of observation group.Before treatment and at 1,3 and 6 months after treatment,clinic spasticity index (CSI) and Fugl-Meyer assessment (FMA),Berg balance scale (BBS) and functional independence measure (FIM) were used to evaluate the efficacy of all groups.Results When compare the assessment results at 1 month after treatment with those before treatment,statistically significant difference in terms of scores of CSI,FMA and FIM were revealed in treatment group and observation group (P ＜ 0.05),but not in the control group (P ＞ 0.05).Within-group comparison with the results at 1 month after treatment,the scores of CSI at 3 and 6 months increased in control group and observation group,while decreased in treatment group(P ＜ 0.05),although the scores of FMA and FIM increased in all groups and the increase was statistically significant only in treatment group(P ＜ 0.05).Between-group comparison of the scores in CSI,FMA and FIM showed no significant difference between the observation and control groups(P ＞ 0.05).It was shown that the scores of BBS at 1,3,and 6 months improved continuously in all groups(P ＜0.05),the improvements in treatment group were significantly greater than that of observation group and control group (P ＜ 0.05).Conclusion Ultrasound-guided botulinum toxin type A injection with AFO could further improve lower limb muscle spasticity,and enhance motor,balance and activities of daily life for stroke patients.

Early application of front-ankle-foot orthosis affects the walking ability and speed of the patients with hemiplegia after stroke / 中国组织工程研究

BACKGROUND:Most of the traumatic brain injury and stroke survivors have foot drop and varus deformity, that need to be treated with ankle-foot orthosis. OBJECTIVE:To investigate the advantages and effect of early application of front-ankle-foot orthosis on the walking function of the patients with hemiplegia after stroke. METHODS:The clinical data of 54 patients with hemiplegia after stroke treated in the Changshu No. 2 People’s Hospital from June 2008 to October 2009 were retrospectively analyzed. The patients treated with front-ankle-foot orthosis were the front group (n=28), and the patients treated with rear-ankle-foot orthosis were the rear group (n=26). Al the patients received 10 m maximum walking speed test, and the recovery of walking function of the patients in two groups were observed daily. RESUTLS AND CONCLUSION:There were no patients exited and dead in the observation period. The activities of daily living Barthel index in the front-ankle-foot orthoses group (60.0±12.9) was significantly higher than that in the rear-ankle-foot orthoses group (59.1±10.9), and there was no significant difference in the activities of daily living Barthel index between two groups (P>0.05). For the 10 m maximum walking speed test, the walking speed of (39.6±11.6) m/min in the front-ankle-foot orthosis group was significantly faster than that of (33.0±12.4) m/min in the rear-ankle-foot orthosis group (P<0.05). Front-ankle-foot orthosis is more appropriate for patients with hemiplegia after stroke to improve the walking speed.

Effects on Foot External Rotation of the Modified Ankle-Foot Orthosis on Post-Stroke Hemiparetic Gait

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 (-3.35degrees and -23.68degrees) than in barefoot and HOAFO conditions (p<0.05). Wearing an HOAFO resulted in significant decreases in hip (0.78degrees, p=0.04) and foot (-17.99degrees, 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.

Effects of Dynamic Ankle-Foot Orthosis on Postural Balance Control in Hemiparetic Patients

OBJECTIVE: To determine the effects of dynamic ankle foot orthosis (AFO) on balance control by comparing it with conventional plastic AFO and barefoot conditions in hemiparetic patients. METHOD: Fifteen hemiparetic patients with brain lesions were recruited for this study. All subjects were capable of standing up independently and had a modified Ashworth score of less than two. The postural control capabilities of the subjects were assessed using the timed up and go (TUG) test, and Tetrax(R) tetra-ataxiametric posturography. The stability index, weight distribution index, and synchronization index were measured at six different head positions with dynamic AFO, conventional AFO and under barefoot conditions. RESULTS: There were nine males and six females, whose average age was 45.1 years. There was a significantly even weight distribution for the dynamic AFO and conventional AFO conditions relative to the barefoot condition in neutral, right-sided head, and left-sided head with eyes closed (p<0.05). And there was significantly increased stability in left sided-head, neck flexed positions with eyes closed for dynamic AFO and conventional AFO (p<0.05). However, there was no significant difference in weight distribution or stability between dynamic and conventional AFO conditions, except the stability in right-sided head position with eyes closed. CONCLUSION: In this study, the balance control of hemiparetic patients with dynamic AFO was better than in the barefoot condition, and was similar to conventional AFO. Therefore, we suggest that dynamic AFO may be a useful orthosis for hemiparetic patients with mild to moderate spasticity with poor balance control and foot drop.

Effect of Hinged Ankle-Foot Orthoses on Standing Balance Control in Children with Bilateral Spastic Cerebral Palsy

PURPOSE: To identify the characteristics of static standing balance and its postural control mechanisms during quiet side-by-side standing and the changes in these measures whilst wearing hinged ankle-foot orthoses (AFOs) in children with bilateral spastic cerebral palsy (CP). MATERIALS AND METHODS: Twenty-one children with bilateral spastic CP (6.10 +/- 1.09 year-old) and 22 typically developing (TD) children (5.64 +/- 0.49 year-old) were recruited. Pressure data were recorded while subjects with or without AFOs stood on dual force platforms and net body center of pressure (CoP) coordinates were calculated from this data. Net body CoP was traced for measuring mediolateral (ML) and anteroposterior (AP) displacement and path length per second. Correlation coefficients between parameters representing ankle, hip, and transverse body rotation strategies were also analyzed. RESULTS: ML and AP displacement and path length per second of the CoP trajectory were higher in children with CP compared to TD children (p < 0.05). There were no significant improvements in these parameters whilst wearing hinged AFOs. Compared to TD children, children with CP used less ankle strategy though more hip and transverse rotation strategies for postural control during quiet standing. Whilst wearing hinged AFOs, the contribution of ankle strategy was significantly increased for ML balance control in children with CP (p < 0.05). CONCLUSION: Hinged AFOs for children with CP may be helpful in improving the postural control mechanisms but not the postural stability in quiet side-by-side standing.

Application of Simple Flexible Ankle-Foot Orthosis / 中国康复理论与实践

@#Objective To explore the effect of the simple flexible ankle-foot orthosis on the hemiplegic patient's gait.Methods There are 22 hemiplegic patients (observation group) and 21 healthy individuals (control group) involved in the study. The parameters of gait are collected and analyzed.Results With the simple AFO, the walking time and knee flexion degree of the patients at Brunnstrom stage Ⅳ and stageⅤ are close to that of healthy individuals. When the patients at Brunnstrom stage Ⅲ walk with plastic AFO and then with the simple flexible AFO, there is a obvious difference in knee flexion degree at the initial stage of standing between the two situations.Conclusion The simple flexible AFO can improve the walking ability of hemiplegic patient with light tip foot.

Effect of Ankle-foot Orthosis on Activities of Daily Living and Walking Ability of Patients with Low Lumbar Spinal Cord Injury / 中国康复理论与实践

@#Objective To observe the effect of ankle-foot orthosis(AFO)on the activities of daily living(ADL)and walking ability of patients with low lumbar spinal cord injury.Methods29 cases with low lumbar spinal cord injury were trained by systematic rehabilitation.According to patients' condition,static AFO or dynamic AFO were assembled for them.All patients were evaluated with Modified Barthel Index(MBI)and Functional Independence Measure(FIM)before and after training,and the walking distances were also measured.ResultsAfter AFO dressed,the ADL scores of patients increased,especially walking ability increased significantly(P<0.05).Of 29 patients,26 cases had outdoor walking ability,3 cases had domestic walking ability.ConclusionSelecting different kinds of AFO according to condition of individual can help patients with low lumbar spinal cord injury to reconstruct their walking ability and improve ability of self-management.

The Effects of Plastic Ankle-foot Orthosis on Elderly Stroke Patients

BACKGROUND: Retraining elderly patients with hemiparesis to walk is a major goal of any stroke rehabilitation program. In particular, an plastic ankle-foot orthosis (AFO) is used to correct a spastic drop foot or equinus foot, which are both commonly seen in spastic stroke related hemiparesis and hemiplegia. This study was performed to investigate the gait pattern with or without plastic AFO in elderly stroke patients. METHOD: The subjects of this study were 20 elderly ambulatory hemiplegic patients. We measured time to walk 10 meters and Berg balance scale (BBS) with or without plastic AFO at the time of admission, 4th week and 12th week. RESULTS: Time to walk and BBS of the stroke patients with plastic AFO significantly improved on transfer and 4 weeks later. But 12 weeks later, time to walk and BBS with plastic AFO did not improve. CONCLUSION: The plastic AFO is helpful for the elderly sroke patients to improve walking speed and BBS in early period of in-patient rehabilitation management.