Browse > Article
http://dx.doi.org/10.12674/ptk.2013.20.1.064

Kinematic Effects of Newly Designed Knee-Ankle-Foot Orthosis With Oil Damper Unit on Gait in People With Hemiparesis  

Park, Hyung-Ki (Dept. of Physical Therapy, Masan University)
Kim, Tack-Hoon (Dept. of Physical Therapy, Hanseo University)
Choi, Houng-Sik (Dept. of Physical Therapy, Hanseo University)
Roh, Jung-Suk (Dept. of Physical Therapy, Hanseo University)
Cynn, Heon-Seock (Dept. of Physical Therapy, College of Health Science, Yonsei University, Dept. of Ergonomic Therapy, The Graduate School of Health Science, Yonsei University)
Kim, Jong-Man (Dept. of Physical Therapy, Division of Health, Seonam University)
Publication Information
Physical Therapy Korea / v.20, no.1, 2013 , pp. 64-73 More about this Journal
Abstract
The purposes of this study were to develop a new orthosis controlling ankle and knee joint motion during the gait cycle and to identify the effects of the newly designed orthosis on gait kinematics and tempospatial parameters, including coordination of the extremities in stroke patients. Fifteen individuals who had sustained a stroke, onset was 16 months, participated in this study. Before application of the measurement equipment the subjects were accustomed to walking on the ankle-foot orthosis (AFO) or stance control knee with knee flexion assisted-oil damper ankle-foot orthosis (SCKAFO) for 5 minutes. Fifteen patients were investigated for 45 days with a 3-day interval between sessions. Measurements were walking in fifteen stroke with hemiparesis on the 3D motion analysis system. Comparison of AFO and SCKAFO are gait pattern. The difference between the AFO and SCKAFO conditions was significant in the gait velocity, step length of the right affected side, stance time of both legs, step-length asymmetry ratio, single-support-time asymmetry ratio, ${\phi}$-thigh angle and ${\phi}$-shank angle in the mid swing (p<.001). Using a SCKAFO in stroke patients has shown similar to normal walking speeds can be attained for walking efficiency and is therefore desirable. In this study, the support time of the affected leg with the SCKAFO was longer than with the AFO and the asymmetry ratio of single support time decreased by more than with the AFO. This indicates that the SCKAFO was effective for improving gait symmetry, single-support-time symmetry. This may be due to the decrease of gait asymmetry. Thus, the newly designed SCKAFO may be useful for promoting gait performance by improving the coordination of the extremity and decreasing gait asymmetry in chronic stroke patients.
Keywords
Gait asymmetry; Gait performance; Stance control knee with knee flexion assisted-oil damper ankle-foot orthosis;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Alexander LD, Black SE, Patterson KK, et al. Association between gait asymmetry and brain lesion location in stroke patients. Stroke. 2009;40(2):537-544.   DOI   ScienceOn
2 Barela JA, Whitall J, Black P, et al. An examination of constraints affecting the intralimb coordination of hemiparetic gait. Hum Mov Sci. 2000;19(2):251-273.   DOI   ScienceOn
3 Brandstater ME, De Bruin H, Gowland C, et al. Hemiplegic gait: Analysis of temporal variables. Arch Phys Med Rehabil. 1983;64(12):583-587.
4 Clark JE, Phillips SJ. A longitudinal study of intralimb coordination in the first year of independent walking: A dynamical systems analysis. Child Dev. 1993;64(4):1143-1157.   DOI   ScienceOn
5 Cress ME, Schechtman KB, Mulrow CD, et al. Relationship between physical performance and self-perceived physical function. J Am Geriatr Soc. 1995;43(2):93-101.   DOI
6 Dang M, Ramsaran KD, Street ME, et al. Estimating the accuracy of the Chedoke-McMaster Stroke Assessment predictive equations for stroke rehabilitation. Physiother Can. 2011;63(3):334-341.   DOI   ScienceOn
7 Ford MP, Wagenaar RC, Newell KM. Phase manipulation and walking in stroke. J Neurol Phys Ther. 2007;31(2):85-91.   DOI
8 Friedman PJ. Gait recovery after hemiplegic stroke. Int Disabil Stud. 1990;12(3):119-122.   DOI
9 Gowland C, Stratford P, Ward M, et al. Measuring physical impairment and disability with the Chedoke-McMaster Stroke Assessment. Stroke. 1993;24(1):58-63.   DOI   ScienceOn
10 Griffin MP, Olney SJ, McBride ID. Role of symmetry in gait performance of stroke subjects with hemiplegia. Gait Posture. 1995;3(3):132-142.   DOI   ScienceOn
11 Harburn KL, Hill KM, Kramer JF, et al. Clinical applicability and test-retest reliability of an external perturbation test of balance in stroke subjects. Arch Phys Med Rehabil. 1995;76(4):317-323.   DOI   ScienceOn
12 Hesse S, Luecke D, Jahnke MT, et al. Gait function in spastic hemiparetic patients walking barefoot, with firm shoes, and with ankle-foot orthosis. Int J Rehabil Res. 1996;19(2):133-141.   DOI
13 Hsu AL, Tang PF, Jan MH. Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke. Arch Phys Med Rehabil. 2003;84(8): 1185-1193.   DOI   ScienceOn
14 Lamontagne A, Fung J, McFadyen BJ, et al. Modulation of walking speed by changing optic flow in persons with stroke. J Neuroeng Rehabil. 2007;4:22-29.   DOI   ScienceOn
15 Lindquist AR, Prado CL, Barros RM, et al. Gait training combining partial body-weight support, a treadmill, and functional electrical stimulation: Effects on post stroke gait. Phys Ther. 2007;87(9):1144-1154.   DOI   ScienceOn
16 Lehmann JF, Esselman PC, Ko MJ, et al. Plastic ankle-foot orthoses: Evaluation of function. Arch Phys Med Rehabil. 1983;64(9):402-407.
17 Nikfekr E, Kerr K, Attfield S, et al. Trunk move ment in Parkinson's disease during rising from seated position. Mov Disord. 2002;17(2):274-282.   DOI   ScienceOn
18 Olney SJ, Griffin MP, McBride ID. Multivariate examination of data from gait analysis of persons with stroke. Phys Ther. 1998;78(8):814-828.   DOI
19 Olney SJ, Richards C. Hemiparetic gait following stroke. Part I: Characteristics. Gait Posture. 1996;4(2):136-148.   DOI   ScienceOn
20 Papaxanthis C, Dubost V, Pozzo T. Similar planning strategies for whole-body and arm movements performed in the sagittal plane. Neuroscience. 2003;117(4):779-783.   DOI   ScienceOn
21 Patterson KK, Parafianowicz I, Danells CJ, et al. Gait asymmetry in community-ambulating stroke survivors. Arch Phys Med Rehabil. 2008;89(2): 304-310.   DOI   ScienceOn
22 Perennou D. Postural disorders and spatial neglect in stroke patients: A strong association. Restor Neurol Neurosci. 2006;24(4-6):319-334.
23 Pietraszewski B, Winiarski S, Jaroszczuk S. Three-dimensional human gait pattern-reference data for normal men. Acta Bioeng Biomech. 2012;14(3):9-16.
24 Potter JM, Evans AL, Duncan G. Gait speed and activities of daily living function in geriatric patients. Arch Phys Med Rehabil. 1995;76(11): 997-999.   DOI   ScienceOn
25 Stoquart GG, Detrembleur C, Palumbo S, et al. Effect of botulinum toxin injection in the rectus femoris on stiff-knee gait in people with stroke: A prospective observational study. Arch Phys Med Rehabil. 2008;89(1):56-61.   DOI   ScienceOn
26 Tyrell CM, Roos MA, Rudolph KS, et al. Influence of systematic increases in treadmill walking speed on gait kinematics after stroke. Phys Ther. 2011;91(3):392-403.   DOI   ScienceOn
27 Waters RL, Garland DE, Perry J, et al. Stiff-legged gait in hemiplegia: Surgical correction. J Bone Joint Surg AM. 1979;61(6A):927-933.   DOI
28 Weinberg B, Nikitczuk J, Fisch A, et al. Development of electro-rheological fluidic resistive actuators for haptic vehicular instrument controls. Smart Mater Struct. 2005;14(6):1107-1119.   DOI   ScienceOn
29 Winter DA. Biomechanics of normal and pathological gait: Implications for understanding human locomotor control. J Motor Behav. 1989;21(4):337-355.   DOI   ScienceOn
30 Yamamoto S, Ebina M, Kubo S, et al. Development of an ankle-foot orthosis with dorsiflexion assist. Part 2: structure and evaluation. J Prosthet Orthot. 1999;11(2):24-28.   DOI
31 Yamamoto S, Ebina M, Iwasaki M, et al. Comparative study of mechanical characteristics of plastic AFOs. J Prosthet Orthot. 1993;5(2): 59-64.   DOI
32 Yamamoto S, Ebina M, Miyazaki S, et al. Development of a new ankle-foot orthosis with dorsiflexion assist. Part 1: Desirable characteristic of ankle-foot orthoses for hemiplegic patients. J Prosthet Orthot. 1997;9(4):174-179.   DOI
33 Yakimovich T, Lemaire ED, Kofman J. Engineering design review of stance-control knee-ankle-foot orthoses. J Rehabil Res Dev. 2009;46(2):257-267.   DOI   ScienceOn