| Summary: | 碩士 === 國立中興大學 === 運動與健康管理研究所 === 104 === Background: Walking disability after stroke is often disturbing because of abnormal synergy in movements. These may include sensorimotor control, muscle weakness and/or spasticity involvement. These conditions may result in inappropriate and involuntary posture of the gait patterns, such as foot inversion and drop foot of the affected lower limb. Insufficient toe clearance during swing phase and loss of stability in the foot placement can be the result. The above mentioned factors increase the fall risk of the patients. Ankle foot orthotics(AFO) is frequently prescribed for hemiparetic patients to correct the ankle joint. A low-temperature ankle foot orthotic called ‘anterior ankle foot orthoses’ can be custom-made for patient by Occupational Therapist and it is commonly used in Asian countries. However, in the previous studies, only a few had reported its functions as providing medio-lateral stability, which corrected the rear-foot inversion, gave adequate toe clearance in the swing phase and demonstrated improvement in walking speed and step length. In our clinical trial, some patients complained of wearing discomfort and inability to fit into ordinary shoes. Patients often had to increase their shoe size to accommodate the anterior AFO. We developed a novel (Chun-Jay) ankle foot orthoses to solve the above complaints. We want to discuss how the orthoses can achieve the same effects of walking performance with the anterior AFO, and increase the user’s compliance. Objective: The purpose of this studies to examine the effect of gait performance and user’s opinion in anterior AFO and Chun-Jay AFO, and then compare the differences. Method: Patients’ gait speed was measured. We also measured cadences, sound/affected step length, step width in 10 meter walking test with 3 conditions, including barefoot, anterior AFO, Chun-Jay AFO in randomly. After walking test, we asked the patient to answer the semi-constructed questionnaire to investigate the user’s opinion. Result: Both the gait parameters of wearing anterior AFO and Chun-Jay AFO had better improvement than those of bare foot. Especially, the gait speed in anterior AFO (P=.036) and cadence in Chun-Jay AFO(P=.036) were significantly increased. And there were no significant differences in gait performance between the two AFOs (P>0.05). The subject’s response was positive with anterior AFO function items (>50%), excluding the items of wearing comfortable and appearance of orthoses. Apart from this, most items among the questionnaire showed satisfaction with Chun-Jay AFO. And the score of Chun-Jay AFO was significantly higher than anterior AFO (P=.041).Cnoclusion: In this study, the result of anterior AFO is similar to the previous studies. And Chun-Jay AFO achieves the same effect as anterior AFO being used to correct the drop foot and immediately increases walking performance, but Chun-Jay AFO gets more satisfaction from the user’s opinion. Therefore, it can be a better clinical selection for hemiplegic patients.
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