The effect of tibia inclination on gait pattern of stroke patients with genu recurvatum who wear an Ankle Foot Orthosis: A pilot study

Abstract

BACKGROUND:

Four hemiplegia post-stroke patients with 10 ${}^{\circ }$ –30 ${}^{\circ }$ genu recurvatum recruited for three-dimensional gait analysis to investigate optimum inclination in a Rigid Tuned Ankle Foot Orthosis (RT-AFO).

OBJECTIVE:

1) To investigate the optimum inclination in a Rigid Tuned Ankle Foot Orthosis (RT-AFO) in order to stabilize stance knee kinematics in the sagittal plane for stroke patients with 10 ${}^{\circ }$ –30 ${}^{\circ }$ genu recurvatum, and 2) to compare the effects of RT-AFO with different inclinations on spatio-temporal parameters.

METHODS:

Three dimensional gait measurements were performed in five conditions for four participants: walk without AFO (T1), walk with RT-AFO in 0 ${}^{\circ }$ inclination (T2), walk with RT-AFO in 5 ${}^{\circ }$ inclination (T3), walk with RT-AFO in 10 ${}^{\circ }$ inclination (T4), and walk with RT-AFO in 15 ${}^{\circ }$ inclination (T5).

RESULT:

Application of tibial inclination in the AFO reduced the genu recurvatum in participants who experienced stroke. Genu recurvatum was significantly reduced in conditions T3, T4 ( $p<$ 0.001) and in T5 ( $p<$ 0.05). Optimum inclination was found at 15 ${}^{\circ }$ tibial inclination measured during mid-stance. This study reported a statistically significant improvement in cadence in condition T4 (RT-AFO 10 ${}^{\circ }$ ) ( $p<$ 0.01). There were no significant results for improvement of walking speed and stride length.

CONCLUSION:

These results highlight the potential to optimize inclination of a Rigid Tuned Ankle Foot Orthosis for patients affected by stroke and also indicate the potential clinical applications of tuning the AFO in rehabilitation treatment of stroke patients.