Article

During gait, the hip flexors generate 40% of the total power.
Nevertheless, no device has been tested extensively for clinical purposes to cope
with weakness in the hip flexors in patients with stroke. The purpose
of this study was to assess the efficacy and safety of a newly developed hip
flexion assist orthosis in adult patients with hemiparesis after stroke. DESIGN:
The study used a prospective, randomized, before-after trial design. The
inclusion criteria were hemiparesis resulting from stroke (onset >/=8 weeks);
ability to walk, even if with assistance; and hip flexion weakness (Medical
Research Council Scale score </=4). METHODS: The main outcome measures were the
10-Meter Walk Test and the Six-Minute Walk Test. Patients also were evaluated
with the Trunk Control Test, the Functional Ambulation Categories, the Motricity
Index, and hip flexor strength on the Medical Research Council Scale. Sixty-two
survivors of stroke were tested in random order with and without the orthosis.
Any adverse event associated with its use was recorded. RESULTS: Both the
Six-Minute Walk Test and the 10-Meter Walk Test scores improved with the use of
the orthosis. A significant negative correlation was found for improvement
between scores on the 2 main outcome measures with the orthosis and the
Functional Ambulation Categories scores. The improvement in Six-Minute Walk Test
scores with the orthosis was related inversely to hip flexor strength.
CONCLUSIONS: The data showed that the use of a hip flexion assist orthosis can
improve gait in patients with poststroke hemiparesis, particularly those with
more severe walking impairment.

Langue : ANGLAIS