Article

OBJECTIVE: To evaluate the effect of a hinged soft knee orthosis on the gait
pattern and symmetry of poststroke patients with chronic symptoms and knee
hyperextension. DESIGN: An 8-week prospective, randomized, controlled study.
SETTING: Outpatient clinic of a Department of Physical Medicine and
Rehabilitation in an academic medical center. SUBJECTS:
We recruited adult
subjects (N = 31) at a minimum of 3 months after their first stroke. All subjects
were able to ambulate independently before their stroke and walked independently
with or without a walking aid at the time of recruitment. Subjects also had
paresis of leg muscles and/or a spasticity pattern resulting in knee
hyperextension. INTERVENTIONS: Each subject was tested 3 times, 4 weeks apart.
Two tests were performed without the hinged soft knee orthosis, and the third
examination was performed with the knee orthosis, after the subject ambulated
with it for 4 weeks. OUTCOME MEASURES: Spatiotemporal gait parameters and
symmetry and paretic knee angle and muscle activation patterns measured with and
without the orthosis. In addition, the Berg Balance Scale, 6-Minute Walk Test,
10-Meter Walk Test (10MWT), and Timed Up and Go test were administered. RESULTS:
The orthosis successfully prevented the paretic knee from hyperextending, and
greater knee flexion was achieved during the swing phase. The results of the Berg
Balance Scale, 6-Minute Walk Test, 10MWT, and Timed Up and Go Test significantly
improved. Although no significant differences were found in spatiotemporal
parameters and gait symmetry, 67.7% of the subjects increased their gait velocity
by more than 0.1 m/s calculated from the 10MWT, which is considered a clinically
meaningful difference on short-distance walks. The muscle activity patterns did
not change while using the orthosis when comparing activation time and peak root
mean square values. CONCLUSIONS: Use of a hinged soft knee orthosis to prevent
genu recurvatum after stroke may be considered a viable option to alleviate
excessive stress from the posterior soft tissues of the paretic knee and to
prevent falls by restoring balance and confidence in the patient and by
increasing swing knee flexion.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS