Decreased Energy Cost and Improved Gait Pattern Using a New Orthosis in Persons With Long-Term Stroke

Abstract

Thijssen DH, Paulus R, van Uden CJ, Kooloos JG, Hopman MT. Decreased energy cost and improved gait pattern using a new orthosis in persons with long-term stroke. Objective To measure energy cost and gait analysis in persons with stroke with and without a newly developed orthosis. Design Immediate and long-term (3wk) intervention (before-after trial). Setting University medical center. Participants Volunteer sample of 27 persons with long-term (range, 0.6–19y) hemiparetic stroke. Intervention Three-week familiarization to the new walking aid. Main Outcome Measures Energy cost (per distance walked), preferred walking speed (PWS), and step length. Energy cost was examined in all subjects while walking on a treadmill at 3 different velocities (PWS, PWS+30%, PWS−30%) during 3 different situations (without orthosis, with orthosis, after 3-wk orthosis familiarization). Spatiotemporal aspects of the gait pattern were examined using a 6-m instrumented walkway system. Results Using the orthosis immediately decreased energy cost in persons with stroke during walking at the PWS ( P<.001) and significantly increased walking speed ( P<.005) and step length ( P<.001). After 3 weeks of familiarization to the orthosis, energy cost at the PWS and at PWS+30% showed further improvement in energy cost ( P<.05). Conclusions The newly developed orthosis immediately decreases energy cost and improves walking speed and step length in persons with long-term stroke. After only 3 weeks of orthosis familiarization, energy cost shows additional improvement.