Abstract
Introduction
Recovering
the ability to walk is an important goal of physical therapy for
patients who have survived cerebrovascular accident (stroke). Orthotics
can provide a reduction in plantar flexion of the ankle, leading to
greater stability in the stance phase of the gait cycle. Postural
insoles can be used to reorganize the tone of muscle chains, which
exerts an influence on postural control through correction reflexes. The
aim of the present study was to perform kinematic and spatiotemporal
analyses of gait in stroke survivors with hemiparesis during postural
insole usage.
Material and Methods
Twenty
stroke victims were randomly divided into two groups: 12 in the
experimental group, who used insoles with corrective elements
specifically designed for equinovarus foot, and eight in the control
group, who used placebo insoles with no corrective elements. Both groups
were also submitted to conventional physical therapy. The subjects were
analyzed immediately following insole placement and after three months
of insole usage. The SMART-D 140® system (BTS Engineering) with eight cameras sensitive to infrared light and the 32-channel SMART-D INTEGRATED WORKSTATION® were used for the three-dimensional gait evaluation.
Results
Significant
improvements were found in kinematic range of movement in the ankle and
knee as well as gains in ankle dorsiflexion and knee flexion in the
experimental group in comparison to the control group after three months
of using the insoles.
Conclusion
Postural
insoles offer significant benefits to stroke survivors regarding the
kinematics of gait, as evidenced by gains in ankle dorsiflexion and knee
flexion after three months of usage in combination with conventional
physical therapy.
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