Article

Identifying and understanding the changes in transfer of momentum
that are directly affected by orthotic intervention are significant factors
related to the improvement of mobility in individuals with hemiplegia.
Objectives: The purpose of this investigation was to use a novel analysis
technique to objectively measure weight transfer during double support (DS) in
healthy individuals and individuals with hemiplegia secondary to stroke with and
without an ankle foot orthosis. Study design: Prospective, Repeated measures,
case-controlled trial. Methods: Participants included 25 adults with
stroke-related hemiplegia >6 months using a prescribed ankle foot orthosis and 12
age-matched healthy controls. Main outcome measures included the weight transfer
point timing (WTP, %DS), maximum total force timing (MTF, %DS), timing difference
between WTP and MTF (MTF-WTP, %DS) and the linearity of loading (LOL, R(2))
during the DS phase of the gait cycle. Results: The WTP and LOL were
significantly different between conditions with and without the ankle foot
orthosis for the affected and unaffected limb in post-stroke individuals, p </=
0.01. The MTF and difference in timing between MTF-WTP were significantly
different during affected limb loading with and without the ankle foot orthosis
in the stroke group, p </= 0.0001 and p = 0.03, respectively. MTF, MTF-WTP and
LOL were significantly different between individuals with stroke (during affected
limb loading) and healthy controls (during right limb loading). Conclusions: This
research established a systematic method for analysing weight transfer during
walking to evaluate the effect of an ankle foot orthosis on loading during double
support in hemiplegic gait. This novel method can be used to elucidate
biomechanical mechanisms behind orthosis-mediated changes in gait patterns and
quantify functional mobility outcomes in rehabilitation. Clinical relevance This
novel approach to orthotic assessment will provide the clinician with needed
objective evidence to select the most effective orthotic intervention to maximize
functional recovery for individuals with hemiplegia secondary to stroke.

Langue : ANGLAIS