OBJECTIVE: The purpose of this study were to investigate the temporospatial, kinematic data and energy consumption in hemiplegic patients according to the types of ankle-foot orthosis (AFO), and to determine the most effective type of AFO for gait training. METHOD: A prospective study was performed for 10 patients with hemiplegia who was able to walk independently at indoor level. The temporospatial, kinematic data and energy consumption were compared in each five different conditions: 1) barefoot, 2) donning AFO with posterior leaf spring (PLS), 3) donning PLS with the distal part of metatarsal head trimmed off (PLS-C), 4) donning hinged PLS (HPLS), 5) donning hinged PLS with the distal part of metatarsal head trimmed off (HPLS-C). RESULTS: With four types of PLS, maximal ankle plantar flexion was significantly decreased, however we didn't find any difference in kinematic data of the pelvis and hip as compared with barefoot and with PLS, HPLS, HPLS-C and maximal knee extension angle was significantly decreased compared with barefoot. With HPLS-C, cadence and walking speed significantly increased and double support time and oxygen cost significantly decreased as compared with barefoot. CONCLUSION: This study showed increased walking speed, decreased energy cost and improvedgait pattern after donning HPLS-C especially in hemiplegic patients. So HPLS-C may be effective in hemiplegic patients for gait training.
Ankle* ; Foot Orthoses* ; Foot* ; Gait Disorders, Neurologic ; Gait* ; Head ; Hemiplegia ; Hip ; Humans ; Knee ; Metatarsal Bones ; Orthotic Devices ; Oxygen ; Pelvis ; Plastics* ; Prospective Studies ; Walking