3D Lower Limb Orthotic Therapy for Hemiplegic Stroke Patients Using an Adjustable Plastic Knee Ankle Foot Orthotic Device

Background:Although an orthotic device of the lower limb improves the functionality of neurological patients, anecdotally clinical experience suggests that the compliance is rather limited.Objectives:The aim was to determine the satisfaction and acceptance of a lower limb orthotic device.Study design:A qualitative observational pilot study with a mix-method design.Methods:Adult neurological patients who had a prescribed lower limb orthotic device were included. One published and clinically used questionnaire about satisfaction (D-Quest) and one ad hoc constructed questionnaire about acceptance of the orthotic device (MIRAD-ACCORT questionnaire) were used for data collection.Results:In total, 33 patients participated (28 ankle–foot orthotic device, 3 knee–ankle–foot orthotic device and 2 other types). In general, they were satisfied about their orthotic device and the services. Less than one-fourth of the patients had some negative comments about the ‘visual aspects’ and the ‘ability to hide’ of their orthotic device. These, however, had a lower priority when compared with functionality, which was reported as a main advantage and is a reason for continuing the use of their orthotic device.Conclusion:Patients were satisfied in relation to their lower limb orthotic device. With regard to acceptance, it can be concluded that factors associated with functionality and comfort are more important than the aesthetic and psychological aspects of the orthotic device.Clinical relevancePatients were satisfied with their lower limb orthotic device. Some patients had some negative comments about the ‘aesthetics aspects’ and the ‘ability to hide’ their orthotic device. However, improvements in functionality were mostly reported as a main advantage and a reason for continuing the use of their orthotic device.

Download Full-text

Effect of Functional Electrical Stimulation of the Gluteus Medius during Gait in Patients following a Stroke

BioMed Research International ◽

10.1155/2020/8659845 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Sota Araki ◽

Masayuki Kawada ◽

Takasuke Miyazaki ◽

Yuki Nakai ◽

Yasufumi Takeshita ◽

...

Keyword(s):

Electrical Stimulation ◽

Lower Limb ◽

Stride Length ◽

Gluteus Medius ◽

Gait Velocity ◽

Inertial Measurement Units ◽

Stroke Patients ◽

Inertial Measurement ◽

Motion Range ◽

Measurement Units

Many stroke patients rely on cane or ankle-foot orthosis during gait rehabilitation. The purpose of this study was to investigate the immediate effect of functional electrical stimulation (FES) to the gluteus medius (GMed) and tibialis anterior (TA) on gait performance in stroke patients, including those who needed assistive devices. Fourteen stroke patients were enrolled in this study (mean poststroke duration: 194.9 ± 189.6 d ; mean age: 72.8 ± 10.7 y ). Participants walked 14 m at a comfortable velocity with and without FES to the GMed and TA. After an adaptation period, lower-limb motion was measured using magnetic inertial measurement units attached to the pelvis and the lower limb of the affected side. Motion range of angle of the affected thigh and shank segments in the sagittal plane, motion range of the affected hip and knee extension-flexion angle, step time, and stride time were calculated from inertial measurement units during the middle ten walking strides. Gait velocity, cadence, and stride length were also calculated. These gait indicators, both with and without FES, were compared. Gait velocity was significantly faster with FES ( p = 0.035 ). Similarly, stride length and motion range of the shank of the affected side were significantly greater with FES (stride length: p = 0.018 ; motion range of the shank: p = 0.02 6). Meanwhile, cadence showed no significant difference ( p = 0.238 ) in gait with or without FES. Similarly, range of motion of the affected hip joint, knee joint, and thigh did not differ significantly depending on FES condition ( p = 0.115 ‐ 0.529 ). FES to the GMed and TA during gait produced an improvement in gait velocity, stride length, and motion range of the shank. Our results will allow therapists to use FES on stroke patients with varying conditions.

Download Full-text

Exercise Stress Testing in Subacute Stroke Patients Using a Combined Upper- and Lower-Limb Ergometer

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2005.03.002 ◽

2005 ◽

Vol 86 (9) ◽

pp. 1860-1866 ◽

Cited By ~ 17

Author(s):

Denise C. Hill ◽

Karen D. Ethans ◽

Don A. MacLeod ◽

Edmund R. Harrison ◽

Jane E. Matheson

Keyword(s):

Lower Limb ◽

Stress Testing ◽

Exercise Stress ◽

Exercise Stress Testing ◽

Stroke Patients ◽

Subacute Stroke

Download Full-text

Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on lower limb spasticity classified by spastic muscle echo intensity in post-stroke patients

Annals of Physical and Rehabilitation Medicine ◽

10.1016/j.rehab.2018.05.417 ◽

2018 ◽

Vol 61 ◽

pp. e182

Author(s):

T. Hara ◽

A. Masahiro ◽

H. Hiroyoshi ◽

K. Kazushige

Keyword(s):

Botulinum Toxin ◽

Lower Limb ◽

Botulinum Toxin A ◽

Echo Intensity ◽

Stroke Patients ◽

Toxin A ◽

Multidisciplinary Rehabilitation ◽

Post Stroke ◽

Limb Spasticity ◽

Lower Limb Spasticity

Download Full-text

LOWER LIMB REHABILITATION ROBOT FOR GAIT TRAINING

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519414400041 ◽

2014 ◽

Vol 14 (06) ◽

pp. 1440004 ◽

Cited By ~ 4

Author(s):

SHUAI GUO ◽

JIANCHENG JI ◽

GUANGWEI MA ◽

TAO SONG ◽

JING WANG

Keyword(s):

Lower Limb ◽

Degrees Of Freedom ◽

Balance Training ◽

Gait Training ◽

Rehabilitation Robot ◽

Stroke Patients ◽

Motion Characteristics ◽

Set Up ◽

Limb Rehabilitation ◽

Lower Limb Rehabilitation

After analyzing the rehabilitation needs of stroke patients and the previous studies on lower limb rehabilitation robot, our lower limb rehabilitation robot is designed for stroke patients' gait and balance training. The robot consists of the mobile chassis, the support column and the pelvis mechanism and it is described in detail. As the pelvis mechanism allows most of the patient's motion degrees of freedom (DOFs), the kinematics model of the mechanism is set up, and kinematics simulation is carried out to study the motion characteristics of the mechanism. After analyzing the calculation and simulation results, the pelvis mechanism is proven to measure up to the movement needs of the paralytic's waist and pelvis in walking rehabilitation process.

Download Full-text

The effectiveness of additional core stability exercises in improving dynamic sitting balance, standing balance, lower-limb spasticity, falls and gait in subacute stroke patients (CORE-trial). Study protocol for a Randomized Controlled Trial

10.21203/rs.3.rs-162002/v1 ◽

2021 ◽

Author(s):

Rosa Cabanas-Valdés ◽

Lidia Boix-Sala ◽

Montserrat Grau-Pellicer ◽

Juan Antonio Guzmán-Bernal ◽

Fernanda Maria Caballero-Gómez ◽

...

Keyword(s):

Lower Limb ◽

Daily Living ◽

Controlled Trial ◽

Core Stability ◽

Standing Balance ◽

Stroke Patients ◽

Randomized Controlled ◽

Limb Spasticity ◽

Lower Limb Spasticity ◽

Dynamic Sitting

Abstract BackgroundTrunk impairment produces disorders of motor control, balance, and gait that are correlated with increased risk of falls and reduced mobility in stroke survivors. This creates disability and dependency to perform their activities of daily living. Alterations in body alignment occur, requiring treatment strategies focused on improving the postural control. bearing. Core stability exercises (CSE) are a good strategy to improve local strength of trunk, dynamic sitting, standing balance, and gait. There is some evidence about its effectiveness but it is still necessary to run a large multicenter trial to ratify that existing evidence.MethodsThis is a single-blind multicenter randomized controlled trial. Two parallel groups are compared and both perform the same type of therapy. A control group (CG) (n=110) performs conventional physiotherapy (CP) (1 hour per session) focused on improving balance. An experimental group (EG) (n=110) performs CSE (30 minutes) in addition to CP (30 minutes) (1 hour/session in total). EG is divided in two subgroups, in which only half of patients (n=55) perform CSE plus transcutaneous electrical nerve stimulation (TENS). Primary outcome measures are dynamic sitting, assessed by Spanish-version of Trunk Impairment Scale and stepping, assessed by Brunel Balance Assessment. Secondary outcomes are postural control, assessed by Postural Assessment Scale for Stroke patients; standing balance and risk of fall assessed by Berg Balance Scale; gait speed by BTS G-Walk (accelerometer); rate of falls, lower-limb spasticity by Modified Ashworth Scale; activities of daily living by Barthel Index; and quality of life by EQ-5D-5L. These are evaluated at baseline (T0), at 3 weeks (T1), at 5 weeks -at the end of the intervention (T2), at 17 weeks (T3) and at 29 weeks (T4). Study duration per patient is 29 weeks (a 5-week intervention, followed by a 24-week post-intervention). DiscussionThe study will provide useful information on the short and long term effects of a physiotherapy rehabilitation program based on core stability exercises performed in subacute phase.Trial registrationClinicalTrials.gov Identifier NCT03975985. Data registration June 5th, 2019. Retrospectively registered. Date of registration in primary registry: June 5, 2019. Protocol version 1

Download Full-text