Impact of Alternate Gait Training Using Knee–Ankle–Foot Orthoses with Oil Damper Ankle Hinge in Patients with Subacute Severe Hemiplegia

Patients with severe hemiplegia along with knee instability require knee–ankle–foot orthoses (KAFOs) for gait training. However, in these patients, it is unclear which type of walking training is more effective to improve gait function. Providing alternate gait training (AGT) improves walking functi...

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Autores principales:	Hiroaki Abe, Kazutaka Nishiyama, Yuichi Yamamoto, Toru Okanuka, Yasuhito Yonezawa, Koji Matsumoto
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	gait training hemiplegia knee–ankle–foot orthoses oil dampers ankle hinge assistive device Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/fa8e01d6a2b540e19de01be766fd90d1
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spelling	oai:doaj.org-article:fa8e01d6a2b540e19de01be766fd90d12021-11-25T16:57:04ZImpact of Alternate Gait Training Using Knee–Ankle–Foot Orthoses with Oil Damper Ankle Hinge in Patients with Subacute Severe Hemiplegia10.3390/brainsci111114302076-3425https://doaj.org/article/fa8e01d6a2b540e19de01be766fd90d12021-10-01T00:00:00Zhttps://www.mdpi.com/2076-3425/11/11/1430https://doaj.org/toc/2076-3425Patients with severe hemiplegia along with knee instability require knee–ankle–foot orthoses (KAFOs) for gait training. However, in these patients, it is unclear which type of walking training is more effective to improve gait function. Providing alternate gait training (AGT) improves walking function in patients with spinal cord injury, but it is still unclear whether this is effective in hemiplegic stroke patients. In this study, we defined “unified AGT” as AGT performed with the same therapeutic concept by physiotherapists. We then investigated whether AGT improved gait function quicker than our traditional gait training in hemiplegic stroke patients. We enrolled 15 subjects with severe hemiplegia and knee instability who had undergone unified AGT using KAFOs with hinged oil dampers at the ankles, and 30 historical control (HC) subjects who had undergone traditional gait training. We used multiple comparison and survival analyses to analyze the differences in the functional independence measure (FIM) gait score changes between the two groups. The multiple comparison revealed a significant increase (<i>p</i> < 0.05) in the FIM gait score compared with its initial score in the subjects with unified AGT. However, this improvement was not seen in the HC subjects. Additionally, the survival analysis of time taken to recover revealed a significant difference between the subjects with unified AGT and HC subjects (<i>p</i> < 0.05). These findings suggest that unified AGT using a KAFO facilitates gait improvement in patients with severe hemiplegia and knee instability.Hiroaki AbeKazutaka NishiyamaYuichi YamamotoToru OkanukaYasuhito YonezawaKoji MatsumotoMDPI AGarticlegait traininghemiplegiaknee–ankle–foot orthosesoil dampers ankle hingeassistive deviceNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENBrain Sciences, Vol 11, Iss 1430, p 1430 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	gait training hemiplegia knee–ankle–foot orthoses oil dampers ankle hinge assistive device Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	gait training hemiplegia knee–ankle–foot orthoses oil dampers ankle hinge assistive device Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Hiroaki Abe Kazutaka Nishiyama Yuichi Yamamoto Toru Okanuka Yasuhito Yonezawa Koji Matsumoto Impact of Alternate Gait Training Using Knee–Ankle–Foot Orthoses with Oil Damper Ankle Hinge in Patients with Subacute Severe Hemiplegia
description	Patients with severe hemiplegia along with knee instability require knee–ankle–foot orthoses (KAFOs) for gait training. However, in these patients, it is unclear which type of walking training is more effective to improve gait function. Providing alternate gait training (AGT) improves walking function in patients with spinal cord injury, but it is still unclear whether this is effective in hemiplegic stroke patients. In this study, we defined “unified AGT” as AGT performed with the same therapeutic concept by physiotherapists. We then investigated whether AGT improved gait function quicker than our traditional gait training in hemiplegic stroke patients. We enrolled 15 subjects with severe hemiplegia and knee instability who had undergone unified AGT using KAFOs with hinged oil dampers at the ankles, and 30 historical control (HC) subjects who had undergone traditional gait training. We used multiple comparison and survival analyses to analyze the differences in the functional independence measure (FIM) gait score changes between the two groups. The multiple comparison revealed a significant increase (<i>p</i> < 0.05) in the FIM gait score compared with its initial score in the subjects with unified AGT. However, this improvement was not seen in the HC subjects. Additionally, the survival analysis of time taken to recover revealed a significant difference between the subjects with unified AGT and HC subjects (<i>p</i> < 0.05). These findings suggest that unified AGT using a KAFO facilitates gait improvement in patients with severe hemiplegia and knee instability.
format	article
author	Hiroaki Abe Kazutaka Nishiyama Yuichi Yamamoto Toru Okanuka Yasuhito Yonezawa Koji Matsumoto
author_facet	Hiroaki Abe Kazutaka Nishiyama Yuichi Yamamoto Toru Okanuka Yasuhito Yonezawa Koji Matsumoto
author_sort	Hiroaki Abe
title	Impact of Alternate Gait Training Using Knee–Ankle–Foot Orthoses with Oil Damper Ankle Hinge in Patients with Subacute Severe Hemiplegia
title_short	Impact of Alternate Gait Training Using Knee–Ankle–Foot Orthoses with Oil Damper Ankle Hinge in Patients with Subacute Severe Hemiplegia
title_full	Impact of Alternate Gait Training Using Knee–Ankle–Foot Orthoses with Oil Damper Ankle Hinge in Patients with Subacute Severe Hemiplegia
title_fullStr	Impact of Alternate Gait Training Using Knee–Ankle–Foot Orthoses with Oil Damper Ankle Hinge in Patients with Subacute Severe Hemiplegia
title_full_unstemmed	Impact of Alternate Gait Training Using Knee–Ankle–Foot Orthoses with Oil Damper Ankle Hinge in Patients with Subacute Severe Hemiplegia
title_sort	impact of alternate gait training using knee–ankle–foot orthoses with oil damper ankle hinge in patients with subacute severe hemiplegia
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/fa8e01d6a2b540e19de01be766fd90d1
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Impact of Alternate Gait Training Using Knee–Ankle–Foot Orthoses with Oil Damper Ankle Hinge in Patients with Subacute Severe Hemiplegia

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