This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hesse, S. Articles by Berteanu, M. Search for Related Content PubMed PubMed Citation Articles by Hesse, S. Articles by Berteanu, M. Pubmed/NCBI databases Medline Plus Health Information Foot Health Related Collections Rehabilitation, Stroke Other Stroke Treatment - Medical

(Stroke. 1999;30:1855-1861.)
© 1999 American Heart Association, Inc.

Original Contributions

Non–Velocity-Related Effects of a Rigid Double-Stopped Ankle-Foot Orthosis on Gait and Lower Limb Muscle Activity of Hemiparetic Subjects With an Equinovarus Deformity

Stefan Hesse, MD; Cordula Werner, MS; Konrad Matthias, MD; Kirker Stephen, MD Michael Berteanu, MD

From the Klinik Berlin, Department Neurological Rehabilitation, Free University Berlin (Germany) (S.H., C.W., K.M.); Disablement Services Center, Addenbrookes Hospital NHS Trust, Cambridge, UK (K.S.); and Department of Physical Medicine and Rehabilitation, University of Bucharest (Romania) (M.B.).

Background and Purpose—This study investigated the non–velocity-related effects of a 1-bar rigid ankle-foot orthosis on the gait of hemiparetic subjects, with particular emphasis on the muscle activity of the paretic lower limb.

Methods—Twenty-one hemiparetic subjects who had been using an ankle-foot orthosis for equinovarus deformity for <1 week participated. Patients walked cued by a metronome at a comparable speed with and without the orthosis. Dependent variables were basic, limb-dependent cycle parameters, gait symmetry, vertical ground reaction forces, sagittal ankle excursions, and kinesiological electromyogram of several lower limb muscles.

Results—The use of the caliper was associated with more dynamic and balanced gait, characterized by longer relative single-stance duration of the paretic lower limb, better swing symmetry, better pivoting over the stationary paretic foot, and better ankle excursions (P<0.05). The functional activity of the paretic quadriceps muscles increased, while the activity of the paretic tibialis anterior muscle decreased (P<0.05).

Conclusions—The orthosis led to a more dynamic and balanced gait, with enhanced functional activation of the hemiparetic vastus lateralis muscle. The study further supports the functional benefits of a rigid ankle-foot orthosis in hemiparetic subjects as an integral part of a comprehensive rehabilitation approach. However, the reduced activity in the tibialis muscle may lead to disuse atrophy and hence long-term dependence on the orthosis.

Key Words: gait • hemiplegia • motor activity • orthotic devices • rehabilitation

This article has been cited by other articles:

				M. Pohl and J. Mehrholz Immediate effects of an individually designed functional ankle-foot orthosis on stance and gait in hemiparetic patients Clinical Rehabilitation, April 1, 2006; 20(4): 324 - 330. [Abstract] [PDF]

				M. Franceschini, M. Massucci, L. Ferrari, M. Agosti, and C. Paroli Effects of an ankle-foot orthosis on spatiotemporal parameters and energy cost of hemiparetic gait Clinical Rehabilitation, April 1, 2003; 17(4): 368 - 372. [Abstract] [PDF]

				W. M. Landau and S. A. Sahrmann Preservation of Directly Stimulated Muscle Strength in Hemiplegia Due to Stroke Arch Neurol, September 1, 2002; 59(9): 1453 - 1457. [Abstract] [Full Text] [PDF]

				D. T Wade Rehabilitation is a way of thinking, not a way of doing Clinical Rehabilitation, June 1, 2002; 16(6): 579 - 581. [PDF]