Article

The purpose of the study was to determine whether and to what extent
the treatment goal of enhancement of weight bearing on an affected lower limb is
achieved in the gait rehabilitation of patients with poststroke hemiparesis,
postprosthetic fitting due to unilateral transtibial amputation, or
postunilateral hip or knee arthroplasty. DESIGN: Nonrandomized prepost study.
Subjects were 26 residents of a geriatric rehabilitation hospital in the initial
stage of gait rehabilitation after poststroke hemiparesis (n = 9), unilateral
total hip or knee joint replacement (n = 11), or unilateral transtibial
amputation with a fitted prosthesis (n = 6). Weight bearing on the hindfoot and
forefoot of the affected limb was measured by using the SmartStep system version
2.2.0, at least once a week, both before and immediately after a gait-training
session. Measurements were performed with the patients using their assistive
devices. RESULTS: In the patients with hemiparesis, there was no significant
difference found between the initial pretraining maximal weight bearing on the
afflicted limb (39% and 50% of body weight on the hindfoot and forefoot,
respectively) and that at discharge (47% and 50% of body weight, respectively).
In patients after hip or knee arthroplasty and in those who underwent prosthetic
fitting, there was a substantial increase found in the loading of the forefoot,
but not of the hindfoot, from the initial evaluation to the time of discharge
(from 43% to 54% of body weight, P = 0.05, in the arthroplasty group, and from
49.6% to 69.5%, P = 0.09, in the prosthetic group). CONCLUSIONS: For elderly
individuals belonging to the studied diagnostic groups, the goal of enhancing
normal weight bearing on the afflicted limb during the time course of 2-3 wks
might be unrealistic.

Langue : ANGLAIS