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Article type: Research Article
Authors: Park, Chaeyooa | Woo, Youngkeunb; * | Won, Jongimb | Kim, Sujinb
Affiliations: [a] Department of Physical Therapy, Jainplus Hospital, Jeonju, Republic of Korea | [b] Department of Physical Therapy, College of Medical Sciences, Jeonju University, Jeonju, Republic of Korea
Correspondence: [*] Corresponding author: Youngkeun Woo, Department of Physical Therapy, College of Medical Sciences, Jeonju University 303, Cheonjam-ro, Wansan-gu, Jeonju 56069, Republic of Korea. Tel.: +82 63 220 3163; Fax: +82 63 220 2054; E-mail: ykwoo92@empas.com.
Abstract: Background:Asymmetric gait patterns are mostly observed in hemiplegic stroke patients. These abnormal gait patterns resulting in abnormal speed, and decreased ability in daily of activity living. Objective:This study aimed to determine the immediate changes in gait parameters and plantar pressure during elevation by wearing an insole on the sound side lower extremity of patients with hemiplegia. Methods:Thirty-six participants were recruited, comprising those with a post-stroke follow-up of ≥3 months and a functional ambulation category score of ≥2. The participants were asked to walk with and without a 1 cm insole in the shoe of their sound side, and the order of wearing or not wearing the insole was randomized. Gait parameters, bilateral gait parameters, and dynamic plantar pressure were measured using the GAITRite Walkway System. Results:Paired t-test was used to examine immediate changes in gait parameters and plantar pressure with and without insoles during walking in the same group. Overall, gait velocity and step length significantly decreased (p < 0.05), whereas step time significantly increased (p < 0.05). The swing phase of the affected sidelower extremities significantly increased (p < 0.05), and the stance phase significantly decreased (p < 0.05). Double-support unloading phase (pre-swing phase) significantly increased (p < 0.05). The changes in plantar pressure were significantly increased in some lateral zones and significantly decreased in the medial zone of the mid-hindfoot, both in terms of pressure per time and peak pressure (p < 0.05). Conclusion:Although this study did not show immediate positive effects on gait parameters and gait cycle, it is expected that sensory input from the sole of the foot through changes in plantar pressure may help improve gait asymmetry and regulate postural symmetry.
Keywords: Affected side, gait, gaitrite, gait parameters, hemiplegia, insole, plantar pressure, stroke, sound side, weight bearing, weight shifting, weight transfer
DOI: 10.3233/RNN-241389
Journal: Restorative Neurology and Neuroscience, vol. 42, no. 2, pp. 167-177, 2024
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