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Clin Rehabil. 2011 Nov;25(11):989-98. doi: 10.1177/0269215511410730. Epub 2011 Jul 12.

Effect of early compensation of distal motor deficiency by the Chignon ankle-foot orthosis on gait in hemiplegic patients: a randomized pilot study.

Author information

1
Université Victor Segalen Bordeaux 2, Handicap et Système Nerveux, Bordeaux, France. mathieu.de-seze@chu-bordeaux.fr

Abstract

OBJECTIVE:

To compare the effect of the Chignon ankle-foot orthosis on gait versus a standard ankle-foot orthosis.

METHOD:

A multicentre randomized study was conducted in seven rehabilitation centres. Hemiplegic patients were recruited after unilateral stroke lasting less than six months. Exclusion criteria were: impossibility to stand for 10 seconds; ankle passive dorsiflexion <5 degrees with knee flexed to 90 degrees; triceps spasticity ≥3/4 on the Ashworth modified scale; diseases that might impair active participation in the study. Thirteen patients were randomized to the Chignon group and 15 to the control group. Included patients were given a standard ankle-foot orthosis or Chignon ankle-foot orthosis. The Chignon ankle-foot orthosis is an articulated double-stopped custom-made orthosis with elements to assist dorsiflexion and plantar flexion. Gait speed improvement (ten-metre test), kinematic assessment, and functional scales were assessed.

RESULTS:

Gain ratio of walking speed with the orthosis increased significantly more in the Chignon group than in the control group at day 0 (27.2  ±  36% versus -0.8  ±  17%; P = 0.006), day 30 (39.9  ±  19% versus 7.5  ±  17%; P = 0.0004) and day 90 (44.6  ±  27% versus 17.1  ±  0.3%; P = 0.04). There was also a significant improvement in kinematic parameters and spasticity in the Chignon group.

CONCLUSION:

Early compensation of distal motor deficiency by the Chignon ankle-foot orthosis improves the immediate gait of hemiplegics more than the standard ankle-foot orthosis and seems to modify motor recovery processes in the legs after stroke.

PMID:
21750010
DOI:
10.1177/0269215511410730
[Indexed for MEDLINE]

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