Effect of early compensation of distal motor deficiency by the Chignon ankle-foot orthosis on gait in hemiplegic patients: a randomized pilot study.

Abstract:

OBJECTIVE:To compare the effect of the Chignon ankle-foot orthosis on gait versus a standard ankle-foot orthosis. METHOD:A multicentre randomized study was conducted in seven rehabilitation centres. Hemiplegic patients were recruited after unilateral stroke lasting less than six months. Exclusion criteria were: impossibility to stand for 10 seconds; ankle passive dorsiflexion <5 degrees with knee flexed to 90 degrees; triceps spasticity ≥3/4 on the Ashworth modified scale; diseases that might impair active participation in the study. Thirteen patients were randomized to the Chignon group and 15 to the control group. Included patients were given a standard ankle-foot orthosis or Chignon ankle-foot orthosis. The Chignon ankle-foot orthosis is an articulated double-stopped custom-made orthosis with elements to assist dorsiflexion and plantar flexion. Gait speed improvement (ten-metre test), kinematic assessment, and functional scales were assessed. RESULTS:Gain ratio of walking speed with the orthosis increased significantly more in the Chignon group than in the control group at day 0 (27.2  ±  36% versus -0.8  ±  17%; P = 0.006), day 30 (39.9  ±  19% versus 7.5  ±  17%; P = 0.0004) and day 90 (44.6  ±  27% versus 17.1  ±  0.3%; P = 0.04). There was also a significant improvement in kinematic parameters and spasticity in the Chignon group. CONCLUSION:Early compensation of distal motor deficiency by the Chignon ankle-foot orthosis improves the immediate gait of hemiplegics more than the standard ankle-foot orthosis and seems to modify motor recovery processes in the legs after stroke.

journal_name

Clin Rehabil

journal_title

Clinical rehabilitation

authors

de Sèze MP,Bonhomme C,Daviet JC,Burguete E,Machat H,Rousseaux M,Mazaux JM

doi

10.1177/0269215511410730

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

989-98

issue

11

eissn

0269-2155

issn

1477-0873

pii

0269215511410730

journal_volume

25

pub_type

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