Effect of Lateral Wedged Insole on the Gait Pattern in Stroke individuals
|Keywords:||外側楔型鞋墊;偏癱;步態;腦中風;cerebrovascular accident;gait;hemiplegia;lateral wedged insole||Issue Date:||2004||Abstract:||
結果：健側腳穿戴5度外楔型鞋墊，其主要作用：（1）站立時增加患側下肢承重從體重的34.80%到38.00% (p=0.007)；（2）垂直方向的地面反作用力，其對稱性指標(SI) 有明顯改善，從60.82%到48.02% (p=0.005)；（3）走路時，整體站立期的SI有明顯改善，從18.55%到11.47% (p=0.033)；（4）在健側下肢，單獨支撐期的垂直地面反作用力總和明顯下降，從5.49 ± 0.34 N/kg/sec到4.86 ± 0.26 N/kg/sec (p=0.026)；以及整體站立期的反作用力平均值明顯下降，從7.21 ± 0.13N/kg 到6.94 ± 0.11 N/kg ( p=0.039)；（5）在健側下肢整個走路的周期中，對側腳離地發生時間的百分比明顯上升(26.80% to 29.85%, p=0.039)和單腳支撐期的時間(0.57 second to 0.52 second, p=0.058)有明顯下降；（6）身體軀幹在走路周期中，側向位移角度的總和有明顯下降(p=0.020)。
Objective: To assess the biomechanical changes in ambulatory first stroke patients during stance and ambulation with and without wearing a 5° laterally wedged insole on the non-paretic side
Method: Randomized cross-sectional design to compare the static standing and self-selected speed walking with and without the wedge under the non-paretic foot. The setting was in Department of Rehabilitation Medicine, National Taiwan University Hospital (NTUH) in Taiwan. The inclusive criteria of sixteen participants were unilateral cerebrovascular accident (CVA) males with hemiparesis, who were asymmetry (symmetry index>10%) in standing, being able to stand independently for up to 3 minutes without rest, to walk on the ground over 5 meters without assistive device, and to understand and follow instructions, as well as without other neurological, and musculoskeletal and disease. Three dimensional motion analysis system and force plates were used for the kinematic and kinetic parameters of gait.
Results: The effect of wearing 5° lateral wedged insole on the non-paretic limb in hemiparetic patients were as follows. (1) It increased the paretic limb weight bearing from 34.80% to 38.00% of body weight. (2) The symmetry index (SI) of vertical ground reaction force (GRF) had been significantly improved after wearing 5° lateral wedged insole in static standing (60.82% to 48.02%, p=0.005). (3) During walking, there were significant improvement in the SI of stance time (18.55% to 11.47%, p=0.033). (4) On the non-paretic limb, the impulse of single support phase and the mean vertical GRF of stance phase decreased significantly (5.49 ± 0.34 N/kg/sec to 4.86 ± 0.26 N/kg/sec, p=0.026; 7.21 ± 0.13N/kg to 6.94 ± 0.11 N/kg,, p=0.039, respectively), but the changes in the paretic limb were not significant. (5) In one gait cycle, there were significant changes in the increase of the percentage of opposite foot off, and the decrease in the time of single support on non-paretic side limb. (26.80% to 29.85% gait cycle, p=0.039 and 0.57 second to 0.52 second, p=0.043, respectively). (6) The integrated area of the thorax lateral sway angle during one gait cycle showed significant decrease (p=0.02).
Conclusion: The simple mechanical device like 5° lateral wedged insole on the non-paretic side would improve the weight bearing and symmetry in hemiparetic patients during stance, but the changes during ambulation were variable.
Keyword: gait, cerebrovascular accident, hemiplegia, lateral wedged insole
|Appears in Collections:||物理治療學系所|
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