Minoru Murayama, PhD, Prosthetist and Orthotist
Jpn J Compr Rehabil Sci 12: 32-37, 2021
Objective: To evaluate the effectiveness of a kneeankle-
foot orthosis (KAFO) with a newly developed
knee extension aid in gait training for stroke patients
with severe leg paralysis.
Methods: The participants were 7 recovering stroke
patients prescribed a KAFO. With the KAFO knee
joint set to allow free flexion, knee flexion angle,
lower limb muscle activity, and time of plantar ground
contact were measured during assisted walking with
the knee extension aid or a conventional support loop.
Results: When first using the knee extension aid, knee
flexion angle at initial ground contact was significantly
decreased and time from heel strike on the paralyzed
side to forefoot strike was prolonged compared with
the support loop. After using the knee extension aid
for 1 week, in addition to the two parameters above,
maximum knee flexion angle during the swing phase,
knee extension displacement from the maximum
flexion angle to initial ground contact, and the muscle
activity ratio of the biceps femoris during the swing
phase were significantly increased compared with the
support loop.
Conclusion: This knee extension aid may be indicated
for patients who have difficulty in initial heel strike
due to excessive knee flexion at the end of the swing
phase.
Key words: stroke, recovery period, knee extension assistance, elastic straps, knee-ankle-foot orthosis