Effect of Torque Heel on Excessive External Rotation of Hemiplegic Foot: Three Dimensional Gait Analysis

ABSTRACT

OBJECTIVE: Excessive external rotation of the hemiplegic foot is a common problem of hemiplegic gait. There has been a few report on etiological investigation and corrective measurement of an excessive external rotation of hemiplegic foot. Thus we present a newly designed Torque heel to correct the external rotation of hemiplegic foot. METHOD: Ten hemiparetic patients with an excessive external rotation of affected foot participated in this study. All of the participants were able to walk at least 10 meters with metal a ankle foot orthosis (AFO) using a single cane. Each of these patients was placed on four tries of walk (1) on a bare foot; (2) with an AFO; (3) with an AFO and a quarter inch of lateral wedge; and (4) with an AFO and the Torque heel . Gait patterns were analysed by the Vicon 370, three dimensional motion analyser. RESULTS: The speed and stride length increased in all tries except for the bare foot walk. Those who walked with the assistive devices showed no difference in the speed and stride length. All the participants showed an increased in external rotation of pelvis and ankle. Those who walked with an AFO and Torque heel presented a decrease in the external rotation of foot and pelvis. The hip and ankle motions of the hemiplegic limbs were not affected with the AFO and Torque heel . A significant degree of correction in pelvic rotation with an AFO and Torque heel was noted. CONCLUSIONS: This study indicates that an AFO with Torque heel is beneficial to the correction of external rotation of a hemiplegic foot. And the excessive external rotation of hemiplegic foot may be due possibly to the external rotation of pelvis.