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

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.ObjectiveTo measure energy cost and gait analysis in persons with stroke with and without a newly developed orthosis.DesignImmediate and long-term (3wk) intervention (before-after trial).SettingUniversity medical center.ParticipantsVolunteer sample of 27 persons with long-term (range, 0.6–19y) hemiparetic stroke.InterventionThree-week familiarization to the new walking aid.Main Outcome MeasuresEnergy 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.ResultsUsing 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).ConclusionsThe 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.