A Narrative Review of Alternate Gait Training Using Knee-ankle-foot Orthosis in Stroke Patients with Severe Hemiparesis

Your doctor can read the 9 pages here and see if any can be translated into recovering 100% of your walking.  Wrong goal again; improved walking is not what survivors want, they want 100% recovery.  Stop forcing your tyranny of low expectations on them.

A Narrative Review of Alternate Gait Training UsingKnee-ankle-foot Orthosis in Stroke Patients withSevere Hemiparesis

Hiroaki ABE, PhD, PT1 , Kei KADOWAKI, PT2 , Naohide TSUJIMOTO, PT3 and Toru OKANUKA, PT4 1)Fukushima Medical University School of Health Sciences, Japan 2)Department of Rehabilitation, Osaki Citizen General Hospital, Japan 3)Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Japan 4)Department of Rehabilitation Medicine, Kohnan Hospital, Japan 

ABSTRACT. 

Impairments resulting from stroke lead to persistent difficulties with walking. Subsequently, an improved walking ability is one of the highest priorities for people living with stroke. (Wrong! 100% recovery is!)The degree to which gait can be restored after a stroke is related to both the initial impairment in walking ability and the severity of paresis of the lower extremities. However, there are some patients with severe motor paralysis and a markedly disrupted corticospinal tract who regain their gait function. Recently, several case reports have described the recovery of gait function in stroke patients with severe hemiplegia by providing alternate gait training. Multiple studies have demonstrated that gait training can induce “locomotor-like” coordinated muscle activity of paralyzed lower limbs in people with spinal cord injury. In the present review, we discuss the neural mechanisms of gait, and then we review case reports on the restoration of gait function in stroke patients with severe hemiplegia.