Affiliations: [a] Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand | [b] Department of Medical Service, Sirindhorn National Medical Rehabilitation Institute, Ministry of Public Health, Nonthaburi, Thailand
Correspondence:
[*]
Corresponding author: Nattapong Polhan, Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, 14 Arun-Aumarin Road, Arun-Aumarin, Bangkoknoi, Bangkok 10700, Thailand. Tel.: +66 9986 3473505; E-mail: nattapong.pol@mahidol.edu.
Abstract: BACKGROUND: Four hemiplegia post-stroke patients with 10∘–30∘ 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∘–30∘ 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∘ inclination (T2), walk with RT-AFO in 5∘ inclination (T3), walk with RT-AFO in 10∘ inclination (T4), and walk with RT-AFO in 15∘ 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∘ tibial inclination measured during mid-stance. This study reported a statistically significant improvement in cadence in condition T4 (RT-AFO 10∘) (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.
