The effect of ankel foot orthosis use in tibialis anterior post stroke: A pilot studie

Background: Stroke is defined as the sudden onset of a focal neurologic deficit due to a presumed local disturbance in the blood supply to the brain. Orthotic treatment protocol in post stroke hemiplegic patients still is controversial topic. Numerous previous studies are concentrated upon providing the posterior heel wedge in outer side mainly with footwear’s heel rising associated with molded Solid Ankle Foot Orthosis (SAFO) but this is an attempt of this study to check the effects of insole posterior heel wedge as well as outsole posterior heel wedge in SAFO on temporal and kinetic gait parameters and activation profile of tibialis anterior muscle in post stroke hemiplegic patients. Aim & Objectives: The aim of the study was to compare between insole and outsole posterior heel wedge in molded solid ankle foot orthosis on working efficiency and activation profile of tibialis anterior muscle of the subject with post stroke hemiplegia. Materials and Methods: 30 subjects with post stroke hemiplegia were included in this study by convenient sampling method. The subjects were given with solid ankle foot orthosis with insole and outsole posterior heel wedge. The temporal and kinetic gait parameters and EMG of T.A muscle was measured using eWalk-NILD (MAT), Force plate and AD instrument power Lab. All the measurements were acquired at the time of measurement (Baseline data), time of discharge (Pre data) and after 4 weeks Post data was taken. Results: Pre-post conditions GRF Fx,Fy,Fz have significantly differences. Some parameters also have the non-significant differences. For all the cases to assist the parameters pre and post condition associated with and without AFO with insole posterior heel wedges on Group A and outsole Posterior heel wedge on Group B values are respected for GRF Fx pre without AFO (p= .147), pre with AFO (p= .037) and post without AFO (p= .253) with AFO (p=.009) For Fy pre without and with AFO (p=.025), (p =.682), post without and with AFO (p= .000), (p= .524) in case of Fz pre without and with AFO (p= .759) , (p= .999) post without and with AFO (p=.117), (p=.404 ). On TA muscle profile have also significant differences between two groups on pre without and with AFO (p=.005), (p= .613) and post without and with AFO (p= .000), (p= .000). Discussion & Conclusion: As per present perspective clinical evident report it is concluded that molded SAFO with outsole posterior heel wedge have a significance impact for positive influences on GRF, without any deficit contraction ( EMG signal) of T.A. muscle profile, as compare to insole posterior wedge with AFO. Key words: Hemiplegic, Gait kinetic parameters, Molded ankle foot orthosis, Insole and Outsole Posterior Heel Wedge.

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Characterization of stimulus response curves obtained with transcranial magnetic stimulation from bilateral tibialis anterior muscles post stroke

Neuroscience Letters ◽

10.1016/j.neulet.2019.134530 ◽

2019 ◽

Vol 713 ◽

pp. 134530

Author(s):

Pooja C. Iyer ◽

Sangeetha Madhavan

Keyword(s):

Transcranial Magnetic Stimulation ◽

Tibialis Anterior ◽

Magnetic Stimulation ◽

Response Curves ◽

Post Stroke ◽

Stimulus Response

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Kinematic and kinetic benefits of implantable peroneal nerve stimulation in people with post-stroke drop foot using an ankle-foot orthosis

Restorative Neurology and Neuroscience ◽

10.3233/rnn-180822 ◽

2018 ◽

Vol 36 (4) ◽

pp. 547-558 ◽

Cited By ~ 3

Author(s):

Frank Berenpas ◽

Sven Schiemanck ◽

Anita Beelen ◽

Frans Nollet ◽

Vivian Weerdesteyn ◽

...

Keyword(s):

Nerve Stimulation ◽

Peroneal Nerve ◽

Drop Foot ◽

Ankle Foot Orthosis ◽

Post Stroke ◽

Peroneal Nerve Stimulation ◽

Foot Orthosis

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Clinical experiences with a convertible thermoplastic knee-ankle-foot orthosis for post-stroke hemiplegic patients

Prosthetics and Orthotics International ◽

10.3109/03093649609164442 ◽

1996 ◽

Vol 20 (3) ◽

pp. 191-194 ◽

Cited By ~ 12

Author(s):

S. Kakurai ◽

M. Akai

Keyword(s):

Gait Training ◽

Inhibitory Effect ◽

Clinical Experiences ◽

Recovery Stage ◽

Physical Impairments ◽

Ankle Foot Orthosis ◽

Post Stroke ◽

Walking Pattern ◽

Accepted Practice ◽

Foot Orthosis

As rehabilitation for post-stroke hemiplegic patients has become widely accepted practice, there has been an increase in patients who are more difficult to treat. In the prescription rationale of orthoses for hemiplegics, the knee-ankle-foot orthosis (KAFO) for the lower limb has generally been underestimated because of its inhibitory effect on the normal walking pattern and also its interference with gait training. The authors had an experience of 28 hemiplegics with severe physical impairments who were fitted with a convertible plastic KAFO. Among these patients, there were 11 cases in which the KAFO was replaced by an ankle-foot orthosis (AFO) within 1.5 to 8 months (average 4 months) following initial prescription when they were able to control their knee actively. Ambulatory capability in these patients was superior to that of the remaining KAFO group. The Barthel index of the AFO group patients was higher than the KAFO group (p<0.01). However neither age, sex, severity of hemiplegia, starting time of rehabilitation following onset of stroke, time of fitting with the orthosis, nor the functional recovery stage were critical factors between the two groups, only the incidence of major complications affected ambulatory capability.

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A Soft Wearable Robotic Ankle-Foot-Orthosis for Post-Stroke Patients

IEEE Robotics and Automation Letters ◽

10.1109/lra.2019.2908491 ◽

2019 ◽

Vol 4 (3) ◽

pp. 2547-2552 ◽

Cited By ~ 17

Author(s):

Junghan Kwon ◽

Ji-Hong Park ◽

Subyeong Ku ◽

YeongHyeon Jeong ◽

Nam-Jong Paik ◽

...

Keyword(s):

Stroke Patients ◽

Ankle Foot Orthosis ◽

Post Stroke ◽

Foot Orthosis

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Association between Physiological and Subjective Aspects of Pain and Disability in Post-Stroke Patients with Shoulder Pain: A Cross-Sectional Study

Journal of Clinical Medicine ◽

10.3390/jcm8081093 ◽

2019 ◽

Vol 8 (8) ◽

pp. 1093 ◽

Cited By ~ 1

Author(s):

Martín-Martín ◽

Membrilla-Mesa ◽

Lozano-Lozano ◽

Galiano-Castillo ◽

Fernández-Lao ◽

...

Keyword(s):

Shoulder Pain ◽

Tibialis Anterior ◽

Pain Perception ◽

Stroke Patients ◽

Pressure Pain ◽

Negatively Associated ◽

Post Stroke ◽

Upper Trapezius ◽

Pain Disability ◽

Pressure Pain Thresholds

Background: Patients often experience pain as a result of a stroke. However, the mechanism of this pain remains uncertain. Our aim was to investigate the relationship between pressure pain thresholds (PPTs) and disability pain in patients with hemiplegic shoulder pain (HSP). Methods: Twenty-six post-stroke patients (age 53.35 ± 13.09 years) and healthy controls (54.35 ± 12.37 years) participated. We investigated spontaneous shoulder pain, disability pain perception through the shoulder pain and disability index (SPADI), and the PPTs over joint C5–C6, upper trapezius, deltoid, epicondyle, second metacarpal, and tibialis anterior, bilaterally. Results: The analysis of variance (ANOVA) showed significant differences in pain between groups (p < 0.001) and differences in the SPADI (p < 0.001) between groups but not between sides for PPTs over deltoid (group: p = 0.007; side: p = 0.750), epicondyle (group: p = 0.001; side: p = 0.848), and tibialis anterior (group: p < 0.001; side: p = 0.932). Pain in the affected arm was negatively associated with PPTs over the affected epicondyle (p = 0.003) and affected tibialis anterior (p = 0.009). Pain (SPADI) appeared negatively correlated with PPTs over the affected epicondyle (p = 0.047), and disability (SPADI) was negatively associated with PPTs over the affected tibialis anterior (p = 0.041). Conclusions: Post-stroke patients showed a relationship between widespread pressure pain hypersensitivity with lower PPT levels and pain disability perception, suggesting a central sensitization mediated by bilateral and symmetric pain patterns.

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The Use of Wearable Sensors for the Movement Assessment on Muscle Contraction Sequences in Post-Stroke Patients during Sit-to-Stand

Sensors ◽

10.3390/s19030657 ◽

2019 ◽

Vol 19 (3) ◽

pp. 657 ◽

Cited By ~ 2

Author(s):

Wei-Chun Hsu ◽

Chao-Chin Chang ◽

Yi-Jia Lin ◽

Fu-Chi Yang ◽

Li-Fong Lin ◽

...

Keyword(s):

Muscle Contraction ◽

Tibialis Anterior ◽

Sagittal Plane ◽

Balance Control ◽

Wearable Sensors ◽

Postural Adjustment ◽

Stroke Patients ◽

Post Stroke ◽

Sit To Stand ◽

Therapeutic Exercises

Electromyography (EMG) sensors have been used to study the sequence of muscle contractions during sit-to-stand (STS) in post-stroke patients. However, the majority of the studies used wired sensors with a limited number of placements. Using the latest improved wearable technology with 16 sensors, the current study was a thorough investigation to evaluate the contraction sequences of eight key muscles on the trunk and bilateral limbs during STS in post-stroke patients, as it became feasible. Multiple wearable sensors for the detection of muscle contraction sequences showed that the post-stroke patients performed STS with abnormal firing sequences, not only in the primary mover on the sagittal plane during raising, but also in the tibialis anterior, which may affect anticipatory postural adjustment in the gluteus medius, which may affect balance control. The abnormal tibialis anterior contraction until the early ascending phase and the delayed firing of the gluteus muscles highlight the importance of whole-kinetic-chain monitoring of contraction sequences using wearable sensors. The findings can be helpful for the design of therapeutic exercises.

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