Efficacy of a newly designed trunk orthosis with joints providing resistive force in adults with post-stroke hemiparesis

2014 ◽  
Vol 40 (1) ◽  
pp. 129-136 ◽  
Author(s):  
Junji Katsuhira ◽  
Nodoka Miura ◽  
Tadashi Yasui ◽  
Takane Mitomi ◽  
Sumiko Yamamoto
Keyword(s):  
Plantar Flexion ◽  
Three Dimensional ◽  
Chronic Phase ◽  
Step Length ◽  
Gait Training ◽  
Kinematic Parameters ◽  
Stroke Patients ◽  
Experimental Conditions ◽  
Resistive Force ◽  
Paretic Limb

Background: Few studies have examined the efficacy of trunk orthoses that support the upper trunk and a paretic limb in stroke patients. To improve stability and alignment of the trunk and pelvis in hemiparetic patients, we developed a newly designed trunk orthosis that provides resistive force through spring joints. Objectives: This study aimed to determine the newly designed trunk orthosis’s biomechanical effects during level walking. Study design: Before-after trials must be better. Methods: Measurements were taken for nine chronic-phase (>2 years post-onset) stroke patients using a three-dimensional motion capture system and force plates under three experimental conditions: self-selected gait speed without the newly designed trunk orthosis, with the newly designed trunk orthosis, and after newly designed trunk orthosis removal. We analyzed and compared spatiotemporal and kinetic parameters of the paretic and non-paretic limbs and kinematic parameters of the trunk and bilateral limbs. Results: Several pre-swing gait parameters (e.g. hip joint flexion moment and ankle joint plantar flexion angle) after newly designed trunk orthosis removal were significantly increased compared to those without newly designed trunk orthosis. Step length of the paretic limb tended to increase after newly designed trunk orthosis removal. Conclusion: The newly designed trunk orthosis effectively modified trunk alignment, but larger improvements in kinetic and kinematic parameters were observed in the bilateral limbs after newly designed trunk orthosis removal than with the newly designed trunk orthosis. Clinical relevance Stroke patients improved only trunk malalignment while wearing the newly designed trunk orthosis. Gait after newly designed trunk orthosis removal was better than with the newly designed trunk orthosis. Positive changes after removal were mostly observed in pre-swing of the hemiparetic limb. The newly designed trunk orthosis might be effective for gait training in stroke patients.

scholarly journals Effects of plantar flexion resistive moment generated by an ankle-foot orthosis with an oil damper on the gait of stroke patients: a pilot study

2012 ◽  
Vol 37 (3) ◽  
pp. 212-221 ◽  
Author(s):  
Sumiko Yamamoto ◽  
Naoki Tomokiyo ◽  
Tadashi Yasui ◽  
Toshikazu Kawaguchi
Keyword(s):  
Plantar Flexion ◽  
Reaction Force ◽  
Three Dimensional ◽  
Chronic Phase ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Ankle Foot Orthosis ◽  
Paretic Limb ◽  
Gait Parameters ◽  
Foot Orthosis

Background: An ankle-foot orthosis with an oil damper was previously developed to assist the first rocker function during gait, but the effects of the amount of resistive moment generated on gait have not been clarified. Objectives: To measure the amount of resistive moment generated by the ankle-foot orthosis with an oil damper during gait and determine its effect on the gait of patients with stroke. Study Design: Preliminary cross-sectional study. Methods: The gait of four patients with stroke in the chronic phase was measured in four conditions: without an ankle-foot orthosis and with the ankle-foot orthosis with an oil damper generating three different amounts of resistive moment. Measurements were taken with a three-dimensional motion analysis system and a specially designed device to determine the resistive moment. Results: The resistive moment was observed in the former half in stance of the paretic limb, and its magnitude was less than 10 N m. Some gait parameters related to terminal stance and preswing were affected by the amount of resistive moment. The forward component of floor reaction force and the shank vertical angle showed peak values when the patients reported feeling most comfortable during gait. Conclusion: Although the resistive moment generated by the ankle-foot orthosis with an oil damper was small, it was sufficient to alter gait. Clinical relevance To maximize the effectiveness of ankle-foot orthoses, it is necessary to know the effects of resistive moment on the gait of patients with stroke. The ankle-foot orthosis with an oil damper assists the first rocker function in gait and also affects the gait in a later phase in stance. The peak values of some gait parameters coincided with patients reporting gait to be most comfortable. It is important to know that ankle-foot orthosis with an oil damper assistance in the first rocker alters the weight acceptance on the paretic limb and affects the gait parameters related to propulsion ability in stance.

scholarly journals The effects of ankle-foot orthoses with plantar flexion stop and plantar flexion resistance using rocker-sole shoes on stroke gait: A randomized-controlled trial

2021 ◽  
Vol 67 (4) ◽  
pp. 449-461
Author(s):  
Aliyeh Daryabor ◽  
Gholamreza Aminian ◽  
Mokhtar Arazpour ◽  
Mina Baniasad ◽  
Sumiko Yamamoto
Keyword(s):  
Controlled Trial ◽  
Plantar Flexion ◽  
Three Dimensional ◽  
Chronic Phase ◽  
Controlled Study ◽  
Foot Orthoses ◽  
Randomized Controlled ◽  
Ankle Foot Orthoses ◽  
Spatiotemporal Parameters ◽  
Single Support Phase

Objectives: This study aims to evaluate the effect of two ankle-foot orthoses (AFOs), AFO with plantar flexion stop (AFO-PlfS), and AFO with plantar flexion resistance (AFO-PlfR), while wearing standard shoes and rocker-sole shoes. Patients and methods: Between November 2017 and July 2018, in this randomized-controlled study, a total of 20 stroke patients (8 males, 12 females; mean age: 48.1 years; range, 33 to 65 years) in chronic phase were randomized to AFO groups (AFO-PlfS group, n=10 and AFO-PlfR group, n=10). Each group received the allocated AFO along with two kinds of shoes (standard shoe and rocker shoe) for a two-week adaptation. Two effects were separately evaluated: The orthotic effect and rocker shoe effect were defined as the evaluation of using an AFO wearing standard shoe compared to only standard shoe, and evaluation of using an AFO wearing rocker shoe compared to an AFO wearing standard shoe, respectively. The gait of each group was measured by three-dimensional motion analysis. Results: A significant orthotic effect was found in both AFO groups in spatiotemporal parameters and maximum ankle dorsiflexion in the single-support phase. Additionally, the AFO-PlfR group showed a significant improvement in the parameters related to the first rocker of gait, but not for AFO-PlfS group concerning the orthotic effect. The rocker shoe effect was found in significant reduction of peak ankle plantar flexor moment and power ankle generation during preswing for both AFO groups. Conclusion: According to the orthotic effect, an AFO-PlfR can create better function in the improvement of parameters related to the first rocker. Although a rocker shoe can facilitate rollover for weight progression in the third rocker of gait, it cannot make a strong push-off function in stroke survivors.

scholarly journals Evaluation of the Effectiveness of Nordic Walking Training in Improving the Gait of Persons with Down Syndrome

2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
Agnieszka Skiba ◽  
Jakub Marchewka ◽  
Amadeusz Skiba ◽  
Szymon Podsiadło ◽  
Iwona Sulowska ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Three Dimensional ◽  
Training Group ◽  
Step Length ◽  
Positive Influence ◽  
Control Group ◽  
Kinematic Parameters ◽  
Nordic Walking ◽  
Infrared Video ◽  
Spatiotemporal Parameters

People with Down syndrome (DS) show dysfunction of gait, expressed by disturbed character of angular changes and values of the spatiotemporal parameters as compared to the physiological norm. It is known that exercises and various activities have positive effect on balance and gait, but there are only a few scientific proofs concerning above-mentioned in people with DS. Furthermore, the effect of Nordic Walking (NW) training on gait in people with DS is unexplored. We enrolled 22 subjects with DS, aged 25-40 years, with moderate intellectual disability. Participants were randomly divided into 2 groups: NW training group which underwent 10 weeks of training at a frequency of 3 times a week and control group with no specific intervention. Subjects were examined twice: 1 week before training and a week immediately after intervention. Gait was evaluated by the Vicon 250: a computerized system of three-dimensional analysis of motion, connected to 5 infrared video cameras. We conducted mixed-design ANOVA model to assess the effects of time and type of training on spatiotemporal parameters. We found significant favorable time by group interaction in the following parameters: step length in right leg: F(1,15) =14,47, p=0.002; left leg accordingly F(1,15) =5,15, p=0.038, cycle length in right leg: F(1,15) =14,48, p=0.002; left leg accordingly F(1,15) =15,09, p=0.001; and gait standardised speed F(1,15) =5,35, p=0.035. Statistically significant changes were observed in numerous kinematic parameters of ankle, knee, pelvis, and shoulder in NW group. Regular NW training has positive influence on selected spatiotemporal and kinematic parameters in people with Down Syndrome and may be an attractive and safe form of rehabilitation.

scholarly journals Evaluation of spatio-temporal parameters of the non-paretic limb in the gait performance of post stroke patients

2021 ◽  
Author(s):  
Rodrigo Andreola Serraglio ◽  
Ana Carolina Pauleto ◽  
Guilherme Augusto de Oliveira
Keyword(s):  
Functional Dependence ◽  
Step Length ◽  
The Body ◽  
Stroke Patients ◽  
Post Stroke ◽  
Swing Time ◽  
Paretic Limb ◽  
Spatio Temporal ◽  
High Level ◽  
Support Phase

The objective of this study is to evaluate the compensation of the non-paretic side in the gait of post-stroke hemiparetic patients submitted to computerized gait analysis in the Centro Hospitalar de Reabilitação Ana Carolina Moura Xavier, Curitiba - PR, in a study carried out in 2015. Spatio-temporal data were evaluated: speed, stride and step length, swing time and support of both members. The sample consisted of twenty individuals with a mean time after stroke of 6.9 months. The results showed that the median speed was equivalent to 16.17% of the normal standard value, stride length to 31.22%, step length of the non-paretic limb to 31.69%. The swing time on the nonparetic side corresponded to 35% of the total cycle and the support time corresponded to 86%. There is a favoring of the paretic limb over the non-paretic one, as a compensation mechanism for weakness and impaired balance. Thus, the non-paretic limb spends more time in the support phase to allow a longer step length of the paretic limb while in swing. In contrast, the paretic limb is unable to support the body in the support phase for a long time, reducing the step length of the non-paretic limb. The significant reduction in gait speed indicates the high level of functional dependence in these patients. If there is an opportunity to act early in the rehabilitation of post-stroke patients, still in the acute phase, it is possible to quantify the improvement in the ability to walk.

scholarly journals Change of rocker function in the gait of stroke patients using an ankle foot orthosis with an oil damper: immediate changes and the short-term effects

2011 ◽  
Vol 35 (4) ◽  
pp. 350-359 ◽  
Author(s):  
Sumiko Yamamoto ◽  
Masako Fuchi ◽  
Tadashi Yasui
Keyword(s):  
Ankle Joint ◽  
Walking Speed ◽  
Chronic Phase ◽  
Gait Training ◽  
Stroke Patients ◽  
Short Term ◽  
Ankle Foot Orthosis ◽  
Spatiotemporal Parameters ◽  
Foot Orthosis ◽  
Short Term Effects

Background: An ankle foot orthosis (AFO) using an oil damper (AFO-OD) to assist the first rocker during gait was previously developed but the effect on the other rocker functions has not been clarified. Objectives: The immediate and short-term effects on the gait of stroke patients with the AFO-OD were investigated from the viewpoint of the rocker function. Study Design: Crossover study. Methods: The gait of eight stroke patients in chronic phase without an AFO, with the AFO-OD, and the gait with AFO-OD after three weeks of continuous use and gait training were measured by 3D motion analysis. Results: Immediate changes observed on use of the AFO-OD were improvements in walking speed, the spatiotemporal parameters, and the angular change of dorsiflexion of the ankle joint. Three weeks of continuous AFO-OD use and gait training showed further improvements in walking speed and the spatiotemporal parameters as well as an increase in dorsiflexion angle and plantar flexor moment of the ankle joint of the paretic limb in stance. Conclusions: These changes produced improvement of the second rocker function, but improvement of the third rocker was insufficient. Results show the importance of gait training to take full advantage of an AFO.

Immediate-term effects of use of an ankle–foot orthosis with an oil damper on the gait of stroke patients when walking without the device

2014 ◽  
Vol 39 (2) ◽  
pp. 140-149 ◽  
Author(s):  
Sumiko Yamamoto ◽  
Setsuro Ibayashi ◽  
Masako Fuchi ◽  
Tadashi Yasui
Keyword(s):  
Ankle Joint ◽  
Three Dimensional ◽  
Chronic Phase ◽  
Therapeutic Effects ◽  
Stroke Patients ◽  
Joint Power ◽  
Ankle Foot Orthosis ◽  
Natural Movement ◽  
Analysis System ◽  
Foot Orthosis

Background:An ankle–foot orthosis using an oil damper is designed to enable natural movement of the ankle joint. Wearing an ankle–foot orthosis using an oil damper has been demonstrated to assist the first rocker in stroke patients, but its effect on their gait when not wearing it is unclear.Objectives:To determine the effect of use of ankle–foot orthosis using an oil damper on the gait of stroke patients with hemiparesis when not wearing the ankle–foot orthosis.Study design:Crossover study.Methods:The gait of eight stroke patients in the chronic phase when not wearing an ankle–foot orthosis was measured, using a three-dimensional motion analysis system, before using the ankle–foot orthosis using an oil damper and then without and with using the ankle–foot orthosis using an oil damper after 3 weeks of use. Differences in gait were compared between the three measurement conditions.Results:Use of ankle–foot orthosis using an oil damper significantly decreased preswing time and significantly increased the positive ankle joint power in stance when not wearing the ankle–foot orthosis using an oil damper.Conclusions:These changes indicate the promising therapeutic effects of ankle–foot orthosis using an oil damper use and suggest the ankle–foot orthosis using an oil damper’s potential as a therapeutic device.Clinical relevanceAfter 3 weeks of use of an ankle–foot orthosis using an oil damper, which assists the first rocker, the gait of stroke patients in the chronic phase when not wearing the ankle–foot orthosis using an oil damper was improved. Preswing time was significantly decreased and positive ankle joint power was significantly increased. The ankle–foot orthosis using an oil damper, which assists the first rocker function with natural movement of the ankle joint during gait, has the potential to improve the gait of stroke patients after immediate-term use.

scholarly journals Análise cinemática da marcha pós protocolo de fadiga global de curta duração

2019 ◽  
Vol 29 (4) ◽  
pp. 35217
Author(s):  
Leandro Viçosa Bonetti ◽  
Filipe Queiroz Triches ◽  
Eduardo Carraro Armiliato ◽  
Gabriel Johann Lazzari ◽  
Vinícius Mazzochi Schmitt ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Plantar Flexion ◽  
Three Dimensional ◽  
Step Length ◽  
Gait Velocity ◽  
Short Term ◽  
Mean Values ◽  
Fatigue Protocol ◽  
Young Subjects ◽  
Flexion And Extension

AIMS: Evaluate the effects of a short-term fatigue protocol on gait’s kinematic parameters of healthy subjects.METHODS: 21 healthy young adults participated in the sample. The parameters of linear kinematics of gait (velocity, cadence, step length, step width, step time) and angular kinematics of gait (hip’s flexion and extension; knee’s flexion and extension; ankle’s dorsiflexion and plantar flexion) were analyzed before and after performing a short-term fatigue protocol. For gait evaluation, a three dimensional gait trajectory capture system was used, consisting of a kinematic system with 7 integrated cameras. The Short-Term Functional Agility Fatigue Protocol, which consists of a short-term global fatigue protocol with series of functional agility exercises, was used to fatigue participants. For comparisons between pre and post fatigue evaluations, the mean values to paired t test, and statistical significance was set as p < 0.05.RESULTS: There were no statistically significant differences in the angular and linear parameters evaluated, except for cadence (p = 0.03).CONCLUSIONS: The short-term global fatigue protocol did not alter the angular and kinematic gait parameters in young subjects, except for the cadence, that was higher after the fatigue protocol.

Articulatory Behavior Pre and Post Full-Mouth Tooth Extraction and Alveoloplasty

1980 ◽  
Vol 23 (3) ◽  
pp. 630-645 ◽  
Author(s):  
Gerald Zimmermann ◽  
J.A. Scott Kelso ◽  
Larry Lander
Keyword(s):  
Control Subject ◽  
High Speed ◽  
Tooth Extraction ◽  
Kinematic Parameters ◽  
Experimental Conditions ◽  
Mean Values ◽  
Articulatory Movements ◽  
The Mean ◽  
Experimental Subjects ◽  
Normal Speech

High speed cinefluorography was used to track articulatory movements preceding and following full-mouth tooth extraction and alveoloplasty in two subjects. Films also were made of a control subject on two separate days. The purpose of the study was to determine the effects of dramatically altering the structural dimensions of the oral cavity on the kinematic parameters of speech. The results showed that the experimental subjects performed differently pre and postoperatively though the changes were in different directions for the two subjects. Differences in both means and variabilities of kinematic parameters were larger between days for the experimental (operated) subjects than for the control subject. The results for the Control subject also showed significant differences in the mean values of kinematic variables between days though these day-to-day differences could not account for the effects found pre- and postoperatively. The results of the kinematic analysis, particularly the finding that transition time was most stable over the experimental conditions for the operated subjects, are used to speculate about the coordination of normal speech.

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