短下肢装具の可撓性と初期角度が片麻痺者の歩行に及ぼす影響

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  • THE EFFECTS OF THE FLEXIBILITY AND INITIAL ANGLE OF ANKLE-FOOT ORTHOSES ON HEMIPLEGIC GAIT

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An experimental ankle-foot orthosis in which the flexibility and initial angle of the ankle joint can be changed arbitrarily was made in order to assess the effect of mechanical property of ankle-foot orthoses on hemiplegic gait. The flexibility of the experimental ankle-foot orthoses was adjusted by changing the elasticity of the spring, and the initial angle was adjusted by changing the length of the spring. The gaits of 15 hemiplegic patients were measured continuously using the experimental ankle-foot orthosis. Temporal factors, the ankle and knee joint angles, and the ankle joint moment were calculated, and the data were analyzed statistically. The following results were obtained. 1) Drop foot during the swing phase was prevented by a more elastic spring. 2) A less elastic spring caused an increase of the dorsiflexion ankle joint moment and a decrease of the plantar flexion angle of the ankle joint at foot contact. 3) Adjustments in dorsiflexion moment by the ankle-foot orthosis that were adequate for the individual patient's disability at foot contact improved the knee joint angle throughout the gait cycle and for all temporal factors. The gaits of 6 hemiplegic patients using the experimental ankle-foot orthosis were measured by force plates and a position-sensitive semiconductor camera system. Results showed that the flexibility and the initial angle of the ankle-foot orthosis affected the knee joint moment. These results are useful in obtaining the criteria to design ankle-foot orthoses which are appropriate for individual hemiplegic patients.

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