Article

A knee-ankle-foot orthosis may be prescribed for the prevention of
genu recurvatum during the stance phase of gait. It allows also to limit abnormal
plantarflexion during swing phase. The aim is to improve gait in hemiplegic
patients and to prevent articular degeneration of the knee. However, the effects
of knee-ankle-foot orthosis on both the paretic and non-paretic limbs during gait
have not been evaluated. The aim of this study was to quantify biomechanical
adaptations induced by wearing a knee-ankle-foot orthosis, on the paretic and
non-paretic limbs of hemiplegic patients during gait. METHODS: Eleven hemiplegic
patients with genu recurvatum performed two gait analyses (without and with the
knee-ankle-foot orthosis). Spatio-temporal, kinematic and kinetic gait parameters
of both lower limbs were quantified using an instrumented gait analysis system
during the stance and swing phases of the gait cycle. FINDINGS: The
knee-ankle-foot orthosis improved spatio-temporal gait parameters. During stance
phase on the paretic side, knee hyperextension was reduced and ankle
plantarflexion and hip flexion were increased. During swing phase, ankle
dorsiflexion increased in the paretic limb and knee extension increased in the
non-paretic limb. The paretic limb knee flexion moment also decreased.
INTERPRETATION: Wearing a knee-ankle-foot orthosis improved gait parameters in
hemiplegic patients with genu recurvatum. It increased gait velocity, by
improving cadence, stride length and non-paretic step length. These
spatiotemporal adaptations seem mainly due to the decrease in knee hyperextension
during stance phase and to the increase in paretic limb ankle dorsiflexion during
both phases of the gait cycle.
CI - Copyright (c) 2012 Elsevier Ltd. All rights reserved.

Langue : ANGLAIS