| Summary: | 碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 98 === Background: Hemiplegic gait is described as slow speed, asymmetry and abnormal gait line. Studies showed that lateral wedged insole significantly improved symmetry of stance when applied under the unaffected leg. However, few studies have investigated effects of wedged insole used under the affected leg for improving gait performance of the stroke patients. Purpose: The study aimed to explore effects of wedged insole when applied to the affected side as compared to the sound side in patients with chronic stroke.
Study design: Randomized crossover. Materials and Methods: Subjects were assigned into two groups: wedge on the affected side or unaffected side first. Each subject was provided a lateral wedge insole of 5-8° for either side and evaluated for gait performance before, immediate after, and one-week after the insole application.
Statistical Analysis: Baseline characteristics and gait performance between the two wedge order groups were compared by using independent t or chi-square tests. Gait performance before and after wedge application between the two groups was analyzed by repeated-measure multivariate analyses of variance (MANOVA). Mann-Whitney U test and Wilcoxon Signed Ranks were use to exam differences on global improvement between the 2 groups; Alpha level was set at 0.05.
Results and Discussion: Forty-one subjects completed the study. We found interactions in (1) Gait line length between the sound and affected sides during insole application on the sound and affected sides, (2) Gait line length between the two wedge order groups during insole application on the sound and affected sides, (3) Velocity between the two wedge order groups during insole application on the sound and affected sides and at different times, (4) Up and go time and ratio of step length symmetry at different times of insole application on the affected side. The subject also reported attaining more improvement when the wedged insole was applied to the affected side.
Conclusion: Wearing laterally wedged insole could improve stroke patients’ walking ability, especially when it was applied to the affected foot.
Key words: Lateral wedge, gait parameter, gait line, stroke
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