Article

Objective: To compare the effect of the Chignon ankle-foot orthosis on gait
versus a standard ankle-foot orthosis. Method: A multicentre randomized study was
conducted in seven rehabilitation centres. Hemiplegic patients were recruited
after unilateral stroke lasting less than six months. Exclusion criteria were : impossibility to stand for 10 seconds; ankle passive dorsiflexion <5 degrees with
knee flexed to 90 degrees ; triceps spasticity >/=3/4 on the Ashworth modified
scale; diseases that might impair active participation in the study. Thirteen
patients were randomized to the Chignon group and 15 to the control group.
Included patients were given a standard ankle-foot orthosis or Chignon ankle-foot orthosis.
The Chignon ankle-foot orthosis is an articulated double-stopped
custom-made orthosis with elements to assist dorsiflexion and plantar flexion.
Gait speed improvement (ten-metre test), kinematic assessment, and functional
scales were assessed. Results: Gain ratio of walking speed with the orthosis
increased significantly more in the Chignon group than in the control group at
day 0 (27.2 +/- 36% versus -0.8 +/- 17%; P = 0.006), day 30 (39.9 +/- 19% versus
7.5 +/- 17%; P = 0.0004) and day 90 (44.6 +/- 27% versus 17.1 +/- 0.3%; P = 0.04). There was also a significant improvement in kinematic parameters and
spasticity in the Chignon group. CONCLUSION: Early compensation of distal motor
deficiency by the Chignon ankle-foot orthosis improves the immediate gait of
hemiplegics more than the standard ankle-foot orthosis and seems to modify motor
recovery processes in the legs after stroke.

Langue : ANGLAIS