Comparison between a novel helical and a posterior ankle-foot orthosis on gait in people with unilateral foot drop: a randomised crossover trial

被引:1
作者
Gasq, David [1 ,2 ]
Dumas, Raphael [3 ]
Causse, Benoit [4 ,5 ]
Scandella, Marino [6 ]
Cintas, Pascal [5 ]
Acket, Blandine [5 ]
Arne-Bes, Marie Christine [5 ]
机构
[1] CHU Toulouse Rangueil, Serv Explorat Fonct Physiol, F-31059 Toulouse, France
[2] Univ Toulouse, Toulouse NeuroImaging Ctr, UPS, Inserm,UMR 1214, F-31024 Toulouse, France
[3] Univ Claude Bernard Lyon 1, Univ Gustave Eiffel, Univ Lyon, LBMC,UMR T 9406, F-69622 Lyon, France
[4] CHU Toulouse Purpan, Ctr Evaluat & Traitement Douleur, Serv Neurochirurg, F-31059 Toulouse, France
[5] CHU Toulouse Purpan, Ctr Reference Malad Neuromusculaires, Dept Neurol, F-31059 Toulouse, France
[6] CHU Toulouse Purpan, Hop Enfants, Lab Anal Marche, F-31059 Toulouse, France
关键词
Orthotic devices; Foot drop; Biomechanics; Six-minute walk test; Neuromuscular disease; Peripheral neuropathy; MARIE-TOOTH DISEASE; PERFORMANCE-MEASURES; GO TEST; PATIENT; STROKE; ASSIST; HIP;
D O I
10.1186/s12984-023-01184-x
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
BackgroundNeuromuscular disease and peripheral neuropathy may cause drop foot with or without evertor weakness. We developed a helical-shaped, non-articulated ankle-foot orthosis (AFO) to provide medial-lateral stability while allowing mobility, to improve gait capacity. Our aim was to evaluate the effect of the helical AFO (hAFO) on functional gait capacity (6-min walk test) in people with peripheral neuropathy or neuromuscular disease (NMD) causing unilateral drop foot and compare with a posterior leaf spring AFO (plsAFO). Secondary aims were to compare functional mobility, 3D kinematic and kinetic gait variables and satisfaction between the AFOs.MethodsSingle centre, randomised crossover trial from January to July 2017 in 20 individuals (14 with peripheral neuropathy and 6 with NMD, 12 females, mean age 55.6 years, SD 15.3); 10 wore the hAFO for the first week and 10 wore the plsAFO before switching for the second week. The 6-min walk test (6MWT), Timed Up and Go (TUG) test and 3D gait analysis were evaluated with the hAFO, the plsAFO and shoes only (noAFO) at inclusion and 1 week after wearing each orthosis. Satisfaction was evaluated with the Quebec user evaluation of satisfaction with assistive technology (QUEST).ResultsMedian [interquartile range] 6MWT distance was greater with the hAFO (444 m [79]) than the plsAFO (389 m [135], P < 0.001, Hedge's g = 0.6) and noAFO (337 m [91], P < 0.001, g = 0.88). TUG time was shorter with the hAFO (8.1 s [2.8]) than the plsAFO (9.5 s [2.6], P < 0.001, g = - 0.5) and noAFO (10.0 s [2.6]), P < 0.001, g = - 0.6). The plsAFO limited plantarflexion during the loading response (plsAFO - 7.5 deg [6.0] vs. noAFO -13.0 deg [10.0], P = 0.0007, g = - 1.0) but the hAFO did not (- 11.0 deg [5.1] vs. noAFO, P = 0.05, g = - 0.5). Quasi-stiffness was lower for the hAFO than plsAFO (P = 0.009, g = - 0.7). The dimensionless eversion moment was higher (though not significantly) with the hAFO than noAFO. Neither orthosis reduced ankle power (P = 0.34). Median total QUEST score was higher for the hAFO (4.7 [0.7]) than the plsAFO (3.6 [0.8]) (P < 0.001, g = 1.9).ConclusionsThe helical orthosis significantly and considerably improved functional gait performance, did not limit ankle mobility, increased lateral stability, though not significantly, and was associated with greater patient satisfaction than the posterior leaf spring orthosis.Trial registration The trial began before registration was mandatory
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页数:13
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