Increased trailing limb angle in hemiplegic patients after training with a knee orthosis: A randomized controlled trial

NeuroRehabilitation. 2024;54(3):485-494. doi: 10.3233/NRE-230372.

Abstract

Background: Stroke often induces gait abnormality, such as buckling knee pattern, compromising walking ability. Previous studies indicated that an adequate trailing limb angle (TLA) is critical for recovering walking ability.

Objective: We hypothesized that correcting gait abnormality by immobilizing the knee joint using a knee orthosis (KO) would improve walking patterns and increase the TLA, and investigated whether walking training using a KO would increase the TLA in post-stroke patients.

Methods: In a randomized controlled trial, thirty-four participants were assigned to KO (walking training using a KO) and non-KO (without using a KO) groups. Twenty-nine completed the three-week gait training protocol. TLA was measured at baseline and after training. A two-way repeated ANOVA was performed to evaluate TLA increases with training type and time as test factors. A t-test compared TLA changes (ΔTLA) between the two groups.

Results: ANOVA showed a main effect for time (F = 64.5, p < 0.01) and interaction (F = 15.4, p < 0.01). ΔTLA was significantly higher in the KO group (14.6±5.8) than in the non-KO group (5.0±7.0, p < 0.001).

Conclusion: Walking training using a KO may be practical and effective for increasing TLA in post-stroke patients.

Keywords: Knee brace; Trailing limb angle; gait abnormality; gait training; walking pattern.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Biomechanical Phenomena
  • Female
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / rehabilitation
  • Hemiplegia* / etiology
  • Hemiplegia* / rehabilitation
  • Humans
  • Knee Joint / physiopathology
  • Male
  • Middle Aged
  • Orthotic Devices*
  • Stroke Rehabilitation* / methods
  • Stroke* / complications
  • Treatment Outcome
  • Walking / physiology