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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
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Europa Medicophysica 2002 June;38(2):57-64

language: English

Energy cost and gait assessment for hemiplegic walking: effects of an ankle-foot orthesis

Franceschini M., Massucci M., Ferrari L., Agosti M., Paroli C.

From the Department of Geriatrics ­and Rehabilitation Hospital of Parma, Parma
*Department of Rehabilitation ASL n. 3 of Umbria, Trevi (Perugia)
**Medical School of Physical Medicine ­and Rehabilitation University of Parma, Parma


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Background. The ­aim of ­this ­study ­was to ­assess ­the effi­cien­cy of ­foot-­ankle ortho­sis in ­the ambu­la­tion of chron­ic hem­i­pleg­ics, in ­terms of func­tion­al­ity, improve­ment of ­space-­time param­e­ters ­and decreas­ing ener­gy ­cost meas­ured by clin­i­cal, func­tion­al ­and instru­men­tal ­aid.
Methods. ­Nine ­patients ­were recruit­ed ­from ­the Walking Analysis Laboratory of ­our Rehabilitation Department. A ­group of ­9 chron­ic hem­i­pleg­ic ­patients ­were eval­u­at­ed dur­ing walk­ing ­with ­and with­out orthe­sis by ­gait anal­y­sis. The out­come meas­ures ­were: Perry ­and Garret Walking Handicap Scale, bas­o­graph­ic anal­y­sis, electromyography (­EMG) ­and ­study of ener­gy ­cost.
Results. ­Our ­study ­shows ­that ­the ­use of ­foot-­ankle orthos­es ­leads to a sig­nif­i­cant improve­ment in walk­ing in chron­ic hem­i­pleg­ic sub­jects. We ­observed ­that ­the ortho­sis cor­rects ­the ­gait pat­tern, sig­nif­i­cant­ly ­improves ­the func­tion­al­ity of walk­ing ­and ­space-­time param­e­ters ­with an impor­tant reduc­tion in ener­gy ­cost with­out affect­ing ener­gy con­sump­tion. Moreover ­there is a sig­nif­i­cant cor­re­la­tion ­between ­the improve-­ment in ­space-­time param­e­ters ­and ­the reduc­tion of ener­gy ­cost.
Conclusions. The orthe­sis, ­even dur­ing ­the clin­i­cal stabil­ity ­phase, ­can ­lead to a sig­nif­i­cant improve­ment in ­patient per­for­mance.

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