Comparison of gait ability according to types of assistive device for ankle joint of chronic hemiplegic stroke survivors

2021 ◽  
Vol 28 (2) ◽  
pp. 30-39
Author(s):  
Dong-Chun Park ◽  
Jung-Hee Jung ◽  
Won-Deuk Kim ◽  
Il-Hyun Son ◽  
Yang-Jin Lee ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Assistive Device ◽  
Stroke Survivors

scholarly journals Measurement of passive ankle stiffness in subjects with chronic hemiparesis using a novel ankle robot

2011 ◽  
Vol 105 (5) ◽  
pp. 2132-2149 ◽  
Author(s):  
Anindo Roy ◽  
Hermano I. Krebs ◽  
Christopher T. Bever ◽  
Larry W. Forrester ◽  
Richard F. Macko ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Frontal Plane ◽  
Chronic Stroke ◽  
Healthy Adults ◽  
Stroke Survivors ◽  
Passive Stiffness ◽  
Mechanical Stiffness ◽  
Treatment Protocols ◽  
Ankle Stiffness ◽  
Hemiparetic Stroke

Our objective in this study was to assess passive mechanical stiffness in the ankle of chronic hemiparetic stroke survivors and to compare it with those of healthy young and older (age-matched) individuals. Given the importance of the ankle during locomotion, an accurate estimate of passive ankle stiffness would be valuable for locomotor rehabilitation, potentially providing a measure of recovery and a quantitative basis to design treatment protocols. Using a novel ankle robot, we characterized passive ankle stiffness both in sagittal and in frontal planes by applying perturbations to the ankle joint over the entire range of motion with subjects in a relaxed state. We found that passive stiffness of the affected ankle joint was significantly higher in chronic stroke survivors than in healthy adults of a similar cohort, both in the sagittal as well as frontal plane of movement, in three out of four directions tested with indistinguishable stiffness values in plantarflexion direction. Our findings are comparable to the literature, thus indicating its plausibility, and, to our knowledge, report for the first time passive stiffness in the frontal plane for persons with chronic stroke and older healthy adults.

scholarly journals Stroke Sarcopenia Patients Cause Weakness and Atrophy in the Knee and Ankle Joints

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 214-214
Author(s):  
Yamanoi Jyunya
Keyword(s):  
Knee Joint ◽  
Ankle Joint ◽  
Muscle Weakness ◽  
Muscle Atrophy ◽  
Lower Limb ◽  
Chronic Stroke ◽  
Triceps Surae ◽  
Stroke Survivors ◽  
Lower Limb Muscle ◽  
Limb Muscle

Abstract Objectives Chronic stroke survivors tend to be inactive, often with sarcopenia, and have decreased physical function and activities of daily living. Muscle atrophy and weakness differ between sarcopenia patients and stroke patients. Therefore, it is difficult to evaluate physiotherapy and intervention for sarcopenic patients with stroke. The purpose of this study was to identify muscles that cause muscle weakness and muscle atrophy in stroke sarcopenia patients. Methods The subjects were 117 chronic stroke survivors who were 65 years or older. Subjects were determined using the criteria of the Asian Working Group on Sarcopenia in 2019 to determine the presence of sarcopenia and were classified into sarcopenia group (SG, n = 60) and non sarcopenia group (nSG, n = 57). Atrophy assessments obtained unaffected lower limb muscle thickness (iliopsoas, gluteus maximus, gluteus medius, hamstrings, quadriceps femoris, tibialis anterior, triceps surae) using B-mode of transverse ultrasound imaging. Strength assessments obtained unaffected lower limb muscle strength (flexion, extension, abduction, adduction, external rotation and internal rotation of hip joint, flexion and extension of knee joint, planter flexion and dorsiflexion of ankle joint) using handheld dynamometer. We conducted a Student's t-test to compare the two groups. A P-value of <0.05 was considered to show statistical significance for all analyses. When the significance level is less than 0.05, the power is also calculated, and it is considered that the significant difference can be secured when P < 0.05 and power >0.8. We conducted with the approval of the ethics committee of Aichi Saiseikai Rehabilitation Hospital (201,908). Results SG had muscle atrophy in all muscles compared to nSG (P < 0.05, power >0.8). SG had muscle weakness in all joint direction compared to nSG (P < 0.05, power >0.8). In particular, extension of knee joint and planter flexion of ankle joint muscle weakness, quadriceps femoris and triceps surae muscle atrophy occurred (P < 0.01, power >0.8). Conclusions Assessment and intervention of skeletal muscle in stroke sarcopenia patients should focus on the knee joint and ankle joint. Funding Sources The authors declare no conflicts of interest associated with this manuscript.

The Effects of Ankle Joint Mobilization on Dorsiflexion Range and Gait Parameters in Chronic Stroke Survivors: A Systematic Review and Meta-analysis

2021 ◽  
pp. 251660852098287
Author(s):  
Hariharasudhan Ravichandran ◽  
Balamurugan Janakiraman
Keyword(s):  
Ankle Joint ◽  
Meta Analysis ◽  
Step Length ◽  
Chronic Stroke ◽  
Gait Velocity ◽  
Stroke Survivors ◽  
Timed Up And Go ◽  
Unaffected Side ◽  
Joint Mobilization ◽  
Gait Parameters

Background: Ankle dorsiflexion movement restriction is a common presentation in most of the chronic stroke survivors. Spasticity and connective tissue changes around ankle, limits dorsiflexion, and interferes with balance and gait performances. Improving functional range of dorsiflexion is essential in post-stroke rehabilitation. Objectives: This meta-analysis analyzed the effects of ankle mobilization techniques in improving dorsiflexion range and gait parameters among chronic stroke survivors. Method: Articles published up to July 2020 were searched in CINAHL, PubMed, Embase, PsyINFO, and OpenGrey. English version of randomized controlled trials (RCTs) assessing the effects of ankle joint mobilization among chronic stroke subjects, with dorsiflexion range of motion (ROM) and gait parameters as outcome, were included. Characteristics of participants, interventions, outcome measure, and measures of variability were extracted. Methodological quality of included trials was assessed using PEDro scale and Cochrane Collaboration tool for the risk of bias. Pooled standardized mean difference was calculated using random effects model for dorsiflexion ROM, gait velocity, step length, cadence, and timed up and go (TUG). Results: Eight RCTs including 226 stroke patients, with mean methodological score of 6 out of 10 in PEDro, were eligible for this meta-analysis. Ankle joint mobilization demonstrated statistically significant improvement on passive dorsiflexion ROM, gait velocity, step length (affected side), and cadence outcomes. Nonsignificance was found in step length (unaffected side) and in TUG. Conclusion: The ankle mobilization techniques are effective in improving passive dorsiflexion ROM, gait velocity, and cadence in chronic stroke survivors. However, the retention effect of ankle mobilization among stroke subjects is not known.

scholarly journals Development of an ankle – foot orthosis with an oil damper

2005 ◽  
Vol 29 (3) ◽  
pp. 209-219 ◽  
Author(s):  
S. Yamamoto ◽  
A. Hagiwara ◽  
T. Mizobe ◽  
O. Yokoyama ◽  
T. Yasui
Keyword(s):  
Mechanical Properties ◽  
Ankle Joint ◽  
Essential Feature ◽  
Plantar Flexion ◽  
Eccentric Contraction ◽  
Assistive Device ◽  
Hip Joints ◽  
Ankle Foot Orthosis ◽  
Paretic Side ◽  
Foot Orthosis

The purpose of the present study was to develop an ankle – foot orthosis (AFO) that satisfies the requirements for an AFO for patients with hemiplegia as determined in a previous study. An oil damper has been introduced as an assistive device. The oil damper provides a resistive moment to plantar flexion of the ankle joint during initial stance on the paretic side. This function improves the insufficient eccentric contraction of the dorsiflexors. The magnitude of the resistive moment generated by this newly developed AFO can be changed easily to adjust its properties in accordance with the requirements of each patient. The mechanical properties of the AFO were measured, and the results showed that the AFO generated a sufficient resistive moment. Hemiplegic gaits with various types of AFOs were assessed, and it was found that the properties of the AFO affected the movements of the ankle, the knee, and the hip joints. The effects of the resistive moment on the alignment of the shank to the floor during initial stance are also discussed. Based on the results of this study, it is concluded that adjustability will be an essential feature for future AFOs.

scholarly journals Does self-initiated sit-to-stand training with an assistive device regain the independence of sit-to-stand in stroke patient? A single-blinded randomized controlled trial

2020 ◽  
Vol 7 ◽  
pp. 205566831986605
Author(s):  
Ng Chee Man Joey ◽  
Woo Ka Ho Marc
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Assistive Device ◽  
Control Group ◽  
Stroke Survivors ◽  
Stand Test ◽  
Positive Effects ◽  
Randomized Controlled ◽  
Sit To Stand ◽  
Hemiparetic Stroke

Background It is unknown whether self-initiated sit-to-stand training with an assistive device is effective to regain the independence of sit-to-stand in stroke survivors. Objective To compare the effectiveness of self-initiated sit-to-stand training with an assistive device with manual sit-to-stand training. Design Parallel randomized controlled, assessor-blinded trial between January 2015 and May 2018. Randomization was performed by drawing lots to allocate treatment groups. Setting A rehabilitation hospital in Hong Kong. Participants 69 participants in medical wards with unilateral hemiparetic stroke. A total of 52 participants fulfilled the study requirements. Intervention Ten sessions of intervention with conventional physiotherapy program followed, by self-initiated sit-to-stand training with an assistive device, or by manual sit-to-stand training. Main outcome measure Number of participants regained the independence of sit-to-stand, sit-to-stand test from the Balance master® and Five-repetition sit-to-stand test. Results 69 participants (intervention, n = 36; control, n = 33) were randomized (mean age, 69.8 years (SD: 10.6), mean post-stroke days 18.6 (SD: 16.0)). Seventeen participants had not completed 10 sessions of training, leaving 52 ( n = 26; n = 26) participants for per protocol analysis. Eighteen participants in the intervention group and 10 participants in the control group had regained the independence of sit-to-stand (Phi and Cramer’s V: –0.31 and 0.31). The participants in the intervention group were faster to complete the Five-repetition sit-to-stand test than the control group (32.7 sec (SD: 1.93) versus 48.4 sec (SD, 6.8); 95% confidence interval, –30.8 to –0.7; p < 0.05). No adverse side effects occurred during and after the training across groups. Conclusions Self-initiated sit-to-stand training with an assistive device may have positive effects on speeding up regaining the independence of sit-to-stand on sub-acute stroke survivors.

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