- 著者
- Minoru Murayama
- 出版者
- The Society of Physical Therapy Science
- 雑誌
- Journal of Physical Therapy Science (ISSN:09155287)
- 巻号頁・発行日
- vol.33, no.4, pp.322-328, 2021 (Released:2021-04-06)
- 参考文献数
- 10
- 被引用文献数
- 6
[Purpose] We aimed to evaluate knee joint movement and muscle activity ratio changes in stroke hemiplegic patients in recovery phase after using a knee-ankle-foot orthosis with an adjustable knee joint for 1 month; we also aimed to discuss the practical implications of our findings. [Participants and Methods] The participants were 8 hemiplegic patients in the recovery phase of stroke who were prescribed knee-ankle-foot orthosis with adjustable knee joint. We measured knee joint angles and electromyographic activity of the vastus medialis and biceps femoris during walking in two conditions: the knee-ankle-foot orthosis knee joint fixed in the extended position and the knee joint moved from 0° to 30° in the flexion direction. Measurements were taken 2 weeks after completion to account for habituation of the orthosis and repeated 1 month later. [Results] When the knee joint was moving from 0° to 30° in the flexion direction, the knee joint angle at initial contact and the minimum flexion angle of the gait cycle decreased significantly between the first and second measurements. When knee joint flexion was 30°, the muscle activity ratio of the vastus medialis increased significantly in the loading response and mid-stance compared to when it was fixed. [Conclusion] Setting the knee joint of a knee-ankle-foot orthosis in accordance with the knee joint movement may increase the muscle activity ratio of the vastus medialis from loading response to mid-stance.
- 著者
- Minoru Murayama
- 出版者
- Kaifukuki Rehabilitation Ward Association
- 雑誌
- Japanese Journal of Comprehensive Rehabilitation Science (ISSN:21855323)
- 巻号頁・発行日
- vol.12, pp.32-37, 2021 (Released:2021-09-03)
- 参考文献数
- 7
- 被引用文献数
- 1
Murayama M. Effectiveness of a knee-ankle-foot orthosis with a knee extension aid in gait training for stroke patients. Jpn J Compr Rehabil Sci 2021; 12: 32-37.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.
- 著者
- Minoru Murayama Sumiko Yamamoto
- 出版者
- The Japanese Association of Rehabilitation Medicine
- 雑誌
- Progress in Rehabilitation Medicine (ISSN:24321354)
- 巻号頁・発行日
- vol.5, pp.20200021, 2020 (Released:2020-09-11)
- 参考文献数
- 21
- 被引用文献数
- 2 6
Objective: Previous studies have suggested that the use of an ankle–foot orthosis may cause disuse atrophy of the tibialis anterior muscle. The objective of this study was to explore gait and muscle activity changes in patients in the recovery phase of stroke with 2-month use of an ankle–foot orthosis that provided plantarflexion resistance.Methods: The participants were 19 patients in the recovery phase of stroke who were prescribed an ankle–foot orthosis that provided plantarflexion resistance. We measured ankle and shank tilt angles as well as electromyography activity of the tibialis anterior and the soleus during 10-m walk tests. Measurements were taken on three occasions. The first was 2 weeks after delivery of the orthosis, 1 and 2 months after the initial measurement, and the third 2 months later. Changes in gait parameters were analyzed between the first and second measurements and between the second and third measurements.Results: Between the second and third measurements, significant increases were observed in plantarflexion and shank forward tilt angles and the activity ratio of the tibialis anterior during loading response compared with other phases.Conclusions: Plantarflexion movement induced by an ankle–foot orthosis with plantarflexion resistance could increase the activity ratio of the tibialis anterior during loading response.