On Effects Of Improved Walking Dysfunction In Stroke Patients With Hemiplegia By Different Elastic Belts

Objective:Walking dysfunction affects the quality of life of stroke patients with hemiplegia.Suitable assistive walking device not only help to restore walking function,but also enhance the patient’s subjective motivation and improve recovery efficiency.The first objective of this study is to investigate the effect of wearing or not wearing a elastic belt on gait parameters and the range of motion of lower limb joints and electromyographic signals during walking and to investigate possible factors for improving walking function.The second objective of this study is to explore the effects of different lengths of elastic belts on gait and to assess patients’ satisfaction with the elastic belts.Methods:In this study,a total of 10 stroke patients from Shanghai Yangzhi Rehabilitation Hospital(Shanghai Sunshine Rehabilitation Center)were recruited to participate in the experiment.Subjects were asked to take a walking test.Vicon motion capture system was used to collect gait parameters,hip,knee and ankle range of motion under four conditions in no elastic belt(NEB),shorter elastic belt(SEB),medium-length elastic belt(MEB)and longer elastic belt(LEB).Noraxon electromyography acquisition system was used to measured the root mean square amplitude values of rectus femoris,anterior tibialis,gastrocnemius and semitendinosus muscles.Patients’ satisfaction with elastic belt was assessed using the Quebec User Evaluation of Satisfaction with assistive Technology(QUEST).A one-way repeated measures ANOVA was used to compare the above results.Results:(1)Gait parameters: The step length of less-affected side and velocity were significantly greater than the NEB for SEB,MEB and LEB(p<0.05),and the gait cycle,percentage of double support phase and stride symmetry ratio were significantly less than the NEB for SEB,MEB and LEB(p<0.05).The results of comparison of step length of affected side,stride width,cadence,percentage of support phase and percentage of swing phase ratio did not show statistical differences(p>0.05).(2)Range of motion of joints: The MEB ankle dorsiflexion-plantar flexion range of motion was significantly greater than the NEB and SEB(p<0.05).There was no statistically significant differences when comparing results for range of motion in the sagittal plane of the knee joint and hip joint,range of motion in the coronal plane of the ankle joint and hip joint,hip internal and external rotation range of motion(p>0.05).(3)Surface EMG parameters: The electromyographic activity of the tibialis anterior muscle was significantly greater in SEB,MEB and LEB than in NEB(p<0.05).The electromyographic activity of the semitendinosus muscle was significantly greater in SEB,MEB and LEB than in NEB(p<0.05).The results of the rectus femoris and gastrocnemius muscles showed no statistical differences(p>0.05).(4)Scores of the QUEST: Satisfaction score for SEB was 3.76±0.97,satisfaction score for MEB was 3.73±0.94 and satisfaction score for LEB was 3.78±1.01.There was no significant effect of satisfaction scores between the three elastic walking belts(p>0.05).Conclusion:(1)The elastic walking belts have a positive effect on the walking function of stroke patients with hemiplegia,increasing walking speed and range of motion of the ankle joint in flexion and extension and assisting in activating lower limb muscles.(2)There is no significant difference in the effect of the three elastic belts on the improvement of walking dysfunction.The patients’ satisfaction with three elastic walking belts was approximately "satisfaction" based on scores of the QUEST.Satisfaction still needs to be improved.