Effects of Different Orthoses Used for Gait Training on Gait Function among          Patients with Subacute Stroke

Fujii, Ryosuke; Sugawara, Hidekazu; Ishikawa, Makoto; Fujiwara, Toshiyuki

doi:10.2490/prm.20200023

Cited by 3 publications

(12 citation statements)

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“…In the most acute stroke patients, orthoses (such as KAFO and AFO) are used for gait training ( Fujii R et al, 2020 , Kakurai S et al, 1996 , Maeshima S et al, 2017 , Nikamp CDM et al, 2017 , Ota T et al, 2018 , Yamanaka T et al, 2004 ). Patients with hemiplegia are fitted with KAFOs for gait training ( Fujii R et al, 2020 , Kakurai S et al, 1996 , Maeshima S et al, 2017 , Ota T et al, 2018 , Yamanaka T et al, 2004 ). As the patient’s gait ability improves, KAFO will be changed to AFO ( Fujii R et al, 2020 , Kakurai S et al, 1996 , Maeshima S et al, 2017 , Ota T et al, 2018 , Yamanaka T et al, 2004 ).…”

Section: Discussionmentioning

confidence: 99%

“…The use of a lower extremity orthosis, such as knee-ankle-foot orthosis (KAFO) and ankle-foot orthosis (AFO), promotes active gait training and facilitates gait recovery ( Maeshima S et al, 2017 , Nikamp CDM et al, 2017 , Ota T et al, 2018 ). A KAFO is usually prescribed when other forms of bracing (such as an AFO) are insufficient to adequately control knee instability due to hemiplegia ( Fujii R et al, 2020 , Hebert JS, 2006 , Kakurai S et al, 1996 , Maeshima S et al, 2017 , Ota T et al, 2018 , Yamanaka T et al, 2004 ). In acute stroke rehabilitation, KAFO are applied to the patients with severe hemiparesis for standing and gait training ( Fujii R et al, 2020 , Kakurai S et al, 1996 , Maeshima S et al, 2017 , Ota T et al, 2018 , Yamanaka T et al, 2004 ).…”

Section: Introductionmentioning

confidence: 99%

“…A KAFO is usually prescribed when other forms of bracing (such as an AFO) are insufficient to adequately control knee instability due to hemiplegia ( Fujii R et al, 2020 , Hebert JS, 2006 , Kakurai S et al, 1996 , Maeshima S et al, 2017 , Ota T et al, 2018 , Yamanaka T et al, 2004 ). In acute stroke rehabilitation, KAFO are applied to the patients with severe hemiparesis for standing and gait training ( Fujii R et al, 2020 , Kakurai S et al, 1996 , Maeshima S et al, 2017 , Ota T et al, 2018 , Yamanaka T et al, 2004 ). It is very difficult for patients to wear the KAFO in their ADL.…”

Section: Introductionmentioning

confidence: 99%

“…It is very difficult for patients to wear the KAFO in their ADL. For the patients with hemiparesis, it is necessary to change the KAFO to the AFO to acquire independent gait ( Fujii R et al, 2020 , Kakurai S et al, 1996 , Maeshima S et al, 2017 , Ota T et al, 2018 , Yamanaka T et al, 2004 ).…”

Section: Introductionmentioning

confidence: 99%

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The development of Ambulation Independence Measure: A new measurement tool to assess gait ability in acute stroke patients

Hayashi

Yamazaki

Takeda

et al. 2022

NRE

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BACKGROUND: The assessment of gait function is important for stroke rehabilitation. Gait function of patients with stroke often depends on the type of orthosis. There are however few gait assessments that assess the type of orthosis. OBJECTIVE: The purpose of this study was to investigate the reliability and validity of our newly developed Ambulation Independence Measure (AIM), which assesses the gait function, type of orthoses and physical assistance, for acute stroke patients. METHODS: A total of 73 acute stroke patients participated in this prospective study. The AIM discriminates 7 levels of gait ability on the basis of the amount of physical assistance required and orthoses that are used during walking. Interrater reliability, concurrent validity with the Functional Ambulation Category (FAC) and predictive validity were examined. RESULTS: The weighted kappas of AIM at the start of gait training (baseline) and discharge were 0.990 and 0.978, respectively. The AIM scores were significantly correlated with the FAC scores at both baseline (r = 0.808) and discharge (r = 0.934). Multiple regression analyses showed that the AIM at baseline was a stronger predictor of the FAC at discharge (R2 = 0.80). CONCLUSIONS: The AIM has excellent reliability, concurrent validity, predictive validity, and good responsiveness in acute stroke patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The development of Ambulation Independence Measure: A new measurement tool to assess gait ability in acute stroke patients

Hayashi

Yamazaki

Takeda

et al. 2022

NRE

Self Cite

View full text Add to dashboard Cite

show abstract

“…The Functional Ambulation Category scale categorizes six levels (0 to 5) of gait assistance [ 22 ]. We have recoded and dichotomized the variable, defining the patients with an FAC score ≤ 2 as non-walkers and those with an FAC score ≥ 3 as walkers [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

Effects of a Music-Based Rhythmic Auditory Stimulation on Gait and Balance in Subacute Stroke

Gonzalez-Hoelling

Bertrán-Noguer

Reig‐Garcia

et al. 2021

IJERPH

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Gait and balance impairments are common after stroke. This study aimed to evaluate the effect of a music-based rhythmic auditory stimulation (RAS) in combination with conventional physiotherapy on gait parameters and walking ability in subacute stroke. This single-blind, historical controlled trial, included 55 patients who had suffered a stroke within the three weeks prior to enrolment. Patients from 2018 (n = 27) were assigned as the historical control group whereas 2019 patients (n = 28) received music-based RAS three times a week. Both groups received 11 h of conventional physiotherapy per week during hospitalization. Primary outcomes were gait and balance parameters (Tinetti test and Timed Up&Go test) and walking ability (Functional Ambulation Category scale). Secondary outcomes were trunk control, assistive devices, functional independence (Functional Independence Measure, Barthel index), and stroke severity and disability (modified Rankin scale, National Institutes of Health Stroke Scale). Results: No between-group differences were identified for gait and balance parameters nor for secondary outcomes. Significant between-group differences were observed in the Functional Ambulation Category: the intervention group (Δmean ± SD; 3.43 ± 1.17) showed greater improvement (p = 0.002) than the control group (Δmean ± SD; 2.48 ± 1.09). Compared with conventional physiotherapy alone, our results suggest that the walking ability of subacute stroke patients might be improved with music-based RAS combined with conventional physiotherapy, but this treatment is not more effective than conventional physiotherapy in obtaining gait and balance gains.

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Quadriceps muscle activity during walking with a knee ankle foot orthosis is associated with improved gait ability in acute hemiplegic stroke patients with severe gait disturbance

Hayashi,

Yamazaki,

Komatsu

et al. 2024

Front. Neurol.

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IntroductionA knee-ankle-foot orthosis (KAFO) prevents knee buckling during walking and enables gait training for acute hemiplegic stroke patients with severe gait disturbances. Although the goal of gait training with a KAFO is to improve gait ability, that is, to acquire walking with an ankle-foot orthosis (AFO), it is not clear how gait training with a KAFO contributes to improving gait ability. Therefore, this study aimed to investigate the relationship between muscle activities during walking with a KAFO and the improvement of gait ability in hemiplegic stroke patients with severe gait disturbance.MethodsA prospective cohort study was conducted. Fifty acute hemiplegic stroke patients who could not walk with an AFO participated. Muscle activities of the paretic rectus femoris, biceps femoris, tibialis anterior, and soleus were assessed with surface electromyogram during walking with a KAFO. Electromyograms were assessed at the beginning of gait training and at the time the Ambulation Independence Measure score improved by 3 or higher, or discharge.ResultsEven in patients with complete hemiplegia, paretic rectus femoris, biceps femoris, and soleus showed periodic muscle activity during walking with a KAFO. Twenty-three patients improved to an Ambulation Independence Measure score of 3 or higher and were able to walk with an AFO (good recovery group). At the beginning of gait training, paretic rectus femoris muscle activity during the first double-limb support phase was significantly higher in the good recovery group than in the poor recovery group. The rectus femoris muscle activity significantly increased from before to after acute rehabilitation, which consisted mainly of gait training with a KAFO.DiscussionFor acute hemiplegic stroke patients with severe disturbance, the induction and enhancement of paretic quadriceps muscle activity during walking with a KAFO play an important role in acquiring walking with an AFO.

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Effects of Different Orthoses Used for Gait Training on Gait Function among Patients with Subacute Stroke

Cited by 3 publications

References 10 publications

The development of Ambulation Independence Measure: A new measurement tool to assess gait ability in acute stroke patients

The development of Ambulation Independence Measure: A new measurement tool to assess gait ability in acute stroke patients

Effects of a Music-Based Rhythmic Auditory Stimulation on Gait and Balance in Subacute Stroke

Quadriceps muscle activity during walking with a knee ankle foot orthosis is associated with improved gait ability in acute hemiplegic stroke patients with severe gait disturbance

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