Impact of Alternate Gait Training Using Knee–Ankle–Foot Orthoses with Oil Damper Ankle Hinge in Patients with Subacute Severe Hemiplegia

Brain Sci., 2021 · DOI: 10.3390/brainsci11111430 · Published: October 28, 2021

Assistive Technology Neurology Rehabilitation

Simple Explanation

This study investigates whether a specific type of gait training, called unified alternate gait training (AGT), improves walking ability faster than traditional gait training in stroke patients with severe leg weakness. AGT involves using knee-ankle-foot orthoses (KAFOs) with hinged oil dampers at the ankles, along with a consistent therapeutic approach by physiotherapists. The study found that patients who underwent unified AGT showed significant improvements in their walking ability sooner than those who received traditional gait training.

Study Duration

Not specified

Participants

15 subjects with severe hemiplegia and 30 historical controls

Evidence Level

Case-matched historical control study

Key Findings

1
The FIM gait score significantly increased in the AGT subjects compared to their initial score at 1, 2, and 3 months.
2
Survival analysis revealed a significant difference between the AGT and HC groups, indicating quicker recovery in the AGT group.
3
All AGT subjects successfully transitioned from KAFOs to AFOs, demonstrating improved gait function.

Research Summary

This study compared the effectiveness of unified alternate gait training (AGT) using knee-ankle-foot orthoses (KAFOs) with traditional gait training in hemiplegic stroke patients. The results showed that AGT led to earlier improvements in gait function, as measured by the Functional Independence Measure (FIM) gait score. The study suggests that AGT using a KAFO can facilitate gait function recovery in patients with severe hemiplegia and knee instability.

Practical Implications

Clinical Practice

Adopting AGT with KAFOs can be a reasonable treatment approach for stroke patients with severe hemiplegia to improve gait function early.

Rehabilitation Programs

Incorporating unified AGT into rehabilitation programs can lead to faster improvements in walking ability and earlier discharge for patients with severe hemiplegia.

Orthotic Devices

The use of KAFOs with oil damper ankle hinges can provide the necessary support and stability to facilitate AGT and improve gait function in stroke patients.

Study Limitations

1
The muscle activities of the lower limbs were not investigated.
2
The number of tested subjects was insufficient.
3
A time bias might exist because the HC group was evaluated prior to AGT becoming the standard of care.

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