Hobbelink, M.S.H. (2015) Providing ankle-foot orthoses in (sub)acute stroke patients: Their short-term effect on spatiotemporal and kinematic parameters and their influence of timing. thesis, Human Movement Sciences.
Full text available on request.Abstract
Background. Ankle-foot orthoses (AFOs) are often prescribed for improving gait impairments in stroke patients. However, short-term effects of providing an AFO on spatiotemporal and kinematic parameters in patients early after stroke are not well studied. Besides, the influence of timing of providing an AFO is unknown. Methods. Subjects for a maximum of six weeks post-stroke (with an AFO-indication) were randomly assigned to the early or late group. The early group received an AFO within one week after inclusion, the late group eight weeks later. Spatiotemporal and kinematic parameters (with and without AFO) were determined after short-term AFO-use (several days). Selected kinematic parameters were ankle (sagittal and frontal), knee (sagittal) and hip (sagittal and frontal) angles at initial contact and foot-off, and minimal and maximal angles during stance and swing. Results. Thirty-three patients were included (16 early, 17 late) and five of them dropped out (one early, four late). AFO-provision resulted in an increased walking velocity (p=0.035) and cadence (p=0.002), a shorter stride duration (p<0.001), a longer relative single support duration (p<0.001), and a shorter relative second double support duration (p=0.002). Five out of six ankle dorsiflexion parameters increased (all p<0.001), and five out of six ankle inversion parameters decreased (p-values ranging from <0.001-0.038). Knee flexion increased at initial contact (p<0.001) and during stance (minimal angle; p=0.025) and swing (minimal angle; p<0.001). Hip flexion increased at initial contact (p<0.001) and during stance (maximal angle; p=0.004). Timing effects showed that ankle dorsiflexion increased more in the early group, and knee flexion increased more in the late group. Conclusions. This study suggests that AFO-provision improves gait impairments at short-term. Marked improvements were found for ankle kinematics, whereas effects on knee kinematics were less pronounced. Improvements in ankle dorsiflexion tend to be larger in the early group, knee flexion tends increase more in the late group. Further research should focus on longitudinal effects. Key Words: Ankle-foot orthosis – Stroke – Timing effect – Short-term effect – Gait – Spatiotemporal – Kinematic
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Nikamp, C.D.M. and Buurke, J.H. and Otter, A.R. den |
| Date Deposited: | 12 Apr 2022 08:19 |
| Last Modified: | 12 Apr 2022 08:19 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3087 |
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