The Effects Of Hemiplegic Walking With Dorsiflexion Ankle Foot Orthosis

Objective The aim of this study was to explore the effects and mechanisms of the patients with hemiplegia by wearing dorsiflexion ankle foot orthosis (DAFO). Meanwhile, gait analysis data may provide experimental evidence for clinical practice .Subjects and Methods Ten male patients and one female with hemiplegic equinus foot were involved in this study (average 42.9±12.6ys, mean height 1.69±0.08m and mean weight 65.4±11.9kg). Nine patients with stroke and 2 patients with brain trauma had affected 7 left and 4 right side lower limbs. The time-space gait parameters were collected by Motion Analysis System. The integrated electromyography (IEMG), peak and mean parameters were collected by surface EMG system. The oxygen cost (OC) was obtained by a Cosmed K4b2 portable gas analysis system. Gait time-distance data and oxygen cost were measured with performing free walking under three conditions: DAFO, FAFO and barefoot. The dynamic electromyogrophy measurements were tested and analyzed on quardriceps, biceps femoris, triceps surae and tibialis anterior.Results①Comparing with barefoot, there is significant increase in stride length (P<0.05), step length (P<0.01), velocity (P<0.01) and cadence (P<0.05) with 5°DAFO. It also shows decrease in stride length time (P<0.05) and step length time (P<0.01). Meanwhile, FAFO can significantly increase in stride length (P<0.05) comparing with barefoot. The walking velocity with 5°DAFO is significant increase (P<0.05). There are significant decrease in the step length time (P<0.05) and stride length time (P<0.05) with 5°DAFO comparing with FAFO. But gait symmetry in two different angles AFO has no significant difference.②Comparing with barefoot, there are no significant difference in electromyography peak in four group muscles with 5°DAFO and FAFO. However, IEMG has significantly increased in triceps surae with 5°DAFO and FAFO (P<0.01). Both can significantly increase in triceps surface EMG.③There are significant differences in OC comparing with barefoot, 5°DAFO and FAFO (P<0.01). However, it is no significant difference between two different AFO(P>0.05).Conclusions DAFO is better than FAFO in improving the walking velocity, step length, stride length and cadence of hemiplegic gait. Both can increase efficiency of triceps surae in walking . Comparing with barefoot, two different AFO both can significantly decrease walking OC in the patients with hemiplegic equinus foot.