Article

Few studies have examined the efficacy of trunk orthoses that support
the upper trunk and a paretic limb in stroke patients.
To improve stability and
alignment of the trunk and pelvis in hemiparetic patients, we developed a newly
designed trunk orthosis that provides resistive force through spring joints.
This study aimed to determine the newly designed trunk orthosis's
biomechanical effects during level walking. STUDY DESIGN: Before-after trials
must be better. METHODS: Measurements were taken for nine chronic-phase (>2 years
post-onset) stroke patients using a three-dimensional motion capture system and
force plates under three experimental conditions: self-selected gait speed
without the newly designed trunk orthosis, with the newly designed trunk
orthosis, and after newly designed trunk orthosis removal. We analyzed and
compared spatiotemporal and kinetic parameters of the paretic and non-paretic
limbs and kinematic parameters of the trunk and bilateral limbs. RESULTS: Several
pre-swing gait parameters (e.g. hip joint flexion moment and ankle joint plantar
flexion angle) after newly designed trunk orthosis removal were significantly
increased compared to those without newly designed trunk orthosis. Step length of
the paretic limb tended to increase after newly designed trunk orthosis removal.
CONCLUSION: The newly designed trunk orthosis effectively modified trunk
alignment, but larger improvements in kinetic and kinematic parameters were
observed in the bilateral limbs after newly designed trunk orthosis removal than
with the newly designed trunk orthosis. CLINICAL RELEVANCE: Stroke patients
improved only trunk malalignment while wearing the newly designed trunk orthosis.
Gait after newly designed trunk orthosis removal was better than with the newly
designed trunk orthosis. Positive changes after removal were mostly observed in
pre-swing of the hemiparetic limb. The newly designed trunk orthosis might be
effective for gait training in stroke patients.
CI - (c) The International Society for Prosthetics and Orthotics 2014.

Langue : ANGLAIS