Effect of Lateral Wedged Insole on the Gait Pattern in Stroke individuals
Date Issued
2004
Date
2004
Author(s)
Chen, Chien-Hsun
DOI
en-US
Abstract
Abstract
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
Subjects
外側楔型鞋墊
偏癱
步態
腦中風
cerebrovascular accident
gait
hemiplegia
lateral wedged insole
Type
other