Article

After foot and/or ankle fracture, the restoration of optimal gait symmetry is one
of the criteria of recovery. Orthotic insoles and orthopaedic shoes improve gait
symmetry and regularity by controlling joint motion and improving alignment. The
aim of the present study was to assess the effect of prescription footwear on
gait quality by using accelerometers attached to the lower back. Sixteen adult
patients with persistent disability after ankle and/or foot fractures performed
two 30-s walking trials with and without prescription footwear (insoles and
stabilizing shoes). Sixteen control subjects were also tested for comparison. The
autocorrelation function was computed from the acceleration signal and the first
two dominant periods were assessed (d1 and d2). Two parameters were used: (1)
Stride Regularity (SR) which expresses the similarity between strides over time
(d2), and (2) Stride Symmetry (SS) a ratio (d1/d2) which expresses the left/right
similarity of gait independently of repeatability in the successive movements of
each limb. In control subjects, SR and SS were 0.86+/-0.05 (correlation
coefficient) and 81+/-10%, respectively. In the patient group, the effect of
footwear was significant (SR: 0.88+/-0.06 vs. 0.90+/-0.05, SS: 38+/-23% vs.
46+/-27%). Pain was also significantly reduced (-34%).
By using a rapid and
low-cost method, we objectively quantified gait quality improvement after
footwear intervention, concomitant to pain reduction. Substantial inter-patient
variability in the footwear outcome was observed. In conclusion, we believe that
trunk accelerometry can be a useful tool in the field of gait rehabilitation.

Langue : ANGLAIS