Effect of a rigid ankle foot orthosis and an ankle foot orthosis with an oil damper plantar flexion resistance on pelvic and thoracic movements of patients with stroke during gait.

Publisher: BioMed Central Country of Publication: England NLM ID: 101147518 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-925X (Electronic) Linking ISSN: 1475925X NLM ISO Abbreviation: Biomed Eng Online Subsets: MEDLINE

Original Publication: London : BioMed Central, [2002-

Foot Orthoses* ; Stroke*/complications ; Stroke*/therapy ; Stroke Rehabilitation*; Humans ; Ankle ; Ankle Joint ; Biomechanical Phenomena ; Gait ; Range of Motion, Articular

Background: Impairments of trunk movements in gait of stroke are often reported. Ankle foot orthosis (AFO) is commonly used to improve gait of stroke; however, the effect of different types of AFOs on the pelvic and thoracic movements during gait in stroke has not been clarified.
Methods: Thirty-four patients with stroke were randomly allocated to undergo 2 weeks of gait training by physiotherapists while wearing a rigid AFO (RAFO) with a fixed ankle or an AFO with an oil damper (AFO-OD) that provides plantarflexion resistance and free dorsiflexion. A motion capture system was used for measurements of shod gait without AFO at baseline and with and without AFO after gait training. Two-way repeated ANOVA, Wilcoxon signed-rank test, and Mann-Whitney U test were performed for the data after the gait training to know the effect of different kinds of AFOs.
Results: Twenty-nine patients completed the study (AFO-OD group: 14, RAFO group: 15). Interactions were found in pelvic rotation angle, change of shank-to-vertical angle (SVA) in the stance, and paretic to non-paretic step length, which increased in AFO-OD group with AFOs (p < 0.05), while the SVA decreased in RAFO group with AFOs (p < 0.05). The main effects were found in pelvic rotation at the contralateral foot off, and thoracic tilt at foot off when an AFO was worn. The change of SVA in stance was positively correlated with the pelvic rotation in the AFO-OD group (r = 0.558). At initial contact, pelvic rotation was positively correlated with thoracic rotation in both groups.
Conclusions: The findings in 29 patients with stroke showed that pelvic and thoracic movements especially the rotation were affected by the type of AFOs. Pelvic rotation and lower limb kinematics exhibited significant improvements with AFO-OD, reflecting more desirable gait performance. On the other hand, the increase in thoracic in-phase rotation might expose the effect of insufficient trunk control and dissociation movement. Trial registration UMIN000038694, Registered 21 November 2019, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_his_list.cgi?recptno=R000044048 .
(© 2023. The Author(s).)

Clin Rehabil. 1999 Aug;13(4):295-300. (PMID: 10460117)
Gait Posture. 2011 Apr;33(4):721-3. (PMID: 21376602)
Prosthet Orthot Int. 2015 Apr;39(2):140-9. (PMID: 24469429)
Prosthet Orthot Int. 2013 Jun;37(3):212-21. (PMID: 23075466)
J Stroke Cerebrovasc Dis. 2004 Mar-Apr;13(2):58-69. (PMID: 17903951)
Clin Biomech (Bristol, Avon). 2014 Nov;29(9):1077-80. (PMID: 25241248)
J Neuroeng Rehabil. 2018 May 23;15(1):41. (PMID: 29792211)
Gait Posture. 2015 Sep;42(3):269-74. (PMID: 26050873)
Gait Posture. 2022 Jan;91:137-148. (PMID: 34695721)
Syst Rev. 2019 Jun 27;8(1):153. (PMID: 31248456)
Prosthet Orthot Int. 2011 Dec;35(4):350-9. (PMID: 21948737)
Gait Posture. 2013 Mar;37(3):457-9. (PMID: 22921491)
Neurologia. 2014 Sep;29(7):423-32. (PMID: 22178049)
Med Eng Phys. 2017 Jun;44:94-101. (PMID: 28284572)
J Bone Joint Surg Am. 1996 Oct;78(10):1506-14. (PMID: 8876578)
J Phys Ther Sci. 2016 Sep;28(9):2426-2429. (PMID: 27799662)
Neurorehabil Neural Repair. 2011 Mar-Apr;25(3):253-8. (PMID: 21041500)
Turk J Phys Med Rehabil. 2017 Jun 03;63(2):143-148. (PMID: 31453442)
Clin Biomech (Bristol, Avon). 2016 Jun;35:81-5. (PMID: 27136122)
Gait Posture. 2018 May;62:268-279. (PMID: 29587246)
Int J Mol Sci. 2020 Oct 15;21(20):. (PMID: 33076218)
Prosthet Orthot Int. 2018 Oct;42(5):544-553. (PMID: 29865941)
J Biomech. 1992 Sep;25(9):1007-15. (PMID: 1517261)
Arch Phys Med Rehabil. 2010 Dec;91(12):1862-8. (PMID: 21112427)
Clin Biomech (Bristol, Avon). 2015 Oct;30(8):775-80. (PMID: 26149007)
Arch Phys Med Rehabil. 2001 Aug;82(8):1057-65. (PMID: 11494185)
Phys Ther. 2015 Aug;95(8):1163-71. (PMID: 25721122)
Gait Posture. 2014 Jul;40(3):457-63. (PMID: 24931112)
J Neuroeng Rehabil. 2022 May 26;19(1):50. (PMID: 35619141)
PM R. 2014 Jul;6(7):635-42. (PMID: 24451335)
Mol Neurobiol. 2020 Oct;57(10):4218-4231. (PMID: 32691303)
Ann Readapt Med Phys. 2003 Apr;46(3):132-7. (PMID: 12763643)
Phys Ther. 2005 Sep;85(9):887-94. (PMID: 16117599)
Gait Posture. 2010 Apr;31(4):444-9. (PMID: 20171890)
Chin Med J (Engl). 2013 Oct;126(20):3869-73. (PMID: 24157148)
Am J Phys Med Rehabil. 2003 Dec;82(12):925-35. (PMID: 14627929)
Prosthet Orthot Int. 2005 Dec;29(3):209-19. (PMID: 16466151)
J Neurol Phys Ther. 2012 Dec;36(4):173-81. (PMID: 23095903)
J Rehabil Med. 2003 Nov;35(6):259-64. (PMID: 14664315)
J Exp Biol. 2021 Aug 15;224(16):. (PMID: 34412111)
Clin Neurophysiol. 2004 Apr;115(4):790-6. (PMID: 15003758)
Clin Biomech (Bristol, Avon). 2017 Jun;45:9-13. (PMID: 28431220)
Gait Posture. 2014 Jan;39(1):105-10. (PMID: 23830524)
Stroke. 2002 Nov;33(11):2626-30. (PMID: 12411652)
Eur J Phys Rehabil Med. 2015 Apr;51(2):185-96. (PMID: 25184801)
J Biomech. 2009 Aug 7;42(11):1673-7. (PMID: 19457488)

2021CZ-11 Fundamental Research Funds for Central Public Welfare Research Institutes; 2020CZ-6 Fundamental Research Funds for Central Public Welfare Research Institutes; 2020YFC2007604 National Key R&D Program of China

Keywords: Ankle–foot orthosis; Biomechanics; Gait; Rehabilitation; Stroke; Trunk movement

Date Created: 20230207 Date Completed: 20230209 Latest Revision: 20240321

20240322

PMC9901085

10.1186/s12938-023-01068-0

36747170