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Europa Medicophysica 2002 June;38(2):57-64

Copyright © 2002 EDIZIONI MINERVA MEDICA

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

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.