| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Relationship between anterior-posterior ground reaction force patterns and immediate effect of different types of ankle-foot orthoses in individuals with post-stroke hemiparesis: a cross-sectional study. |
| 掲載誌名 | 正式名：Journal of neuroengineering and rehabilitation 略 称：J Neuroeng Rehabil ISSNコード：17430003/17430003 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 23(1),pp.70 |
| 著者・共著者 | Yuta Chujo, Naoto Mano, Kimihiko Mori, Takayuki Kuwabara, Hiroaki Tanaka, Jin Kuramoto, Ayami Fujiwara, Kiichi Kajihara, Minami Rokutani, Tomotaka Morikawa, Masanori Wakida, Kimitaka Hase |
| 発行年月 | 2026/01 |
| 概要 | BACKGROUND:Ankle-foot orthoses (AFOs) are commonly prescribed to improve gait after stroke; however, their effectiveness varies among individuals. Limited evidence exists on how AFOs specifically influence ground reaction force (GRF) patterns during gait. This study investigated how baseline anterior-posterior GRF (A-P GRF) patterns, reflecting braking and propulsive abilities, influence the immediate effects of distinct AFO designs.METHODS:This retrospective cross-sectional study included 66 community-dwelling individuals with hemiparesis who underwent gait analysis under three conditions: without AFO (noAFO), with oil-damper AFO (odAFO), and with plastic AFO (pAFO). A-P GRF impulse and mean were assessed across four stance phase bins (Bin 1: initial double support following heel contact, Bin 2: first half of the single support, Bin 3: second half of the single support, Bin 4: terminal double support preceding toe-off), alongside gait speed and limb kinematics. Hierarchical cluster analysis identified distinct A-P GRF patterns based on the impulse from Bins 1-4 during the baseline noAFO condition; immediate AFO effects were compared across clusters.RESULTS:Both AFO types significantly but modestly increased gait speed overall, with variable responses across clusters. Three baseline A-P GRF patterns were identified: favorable propulsion (Cluster 1, n = 19), moderate impairment (Cluster 2, n = 27), and poor propulsion with excessive braking (Cluster 3, n = 20). Participants with the poorest gait function (Cluster 3) demonstrated the most significant improvements in gait speed with both AFO types (odAFO: p < 0.001; pAFO: p = 0.006), through different biomechanical mechanisms: odAFO improved propulsive forces in Bin 4 (impulse: p < 0.001; mean: p = 0.012), whereas pAFO reduced excessive braking forces in Bin 1 (impulse: p < 0.001; mean: p = 0.048). Participants with favorable baseline A-P GRF patterns showed minimal immediate effects.CONCLUSION:AFO effectiveness depends on baseline A-P GRF patterns, with the greatest benefits observed in participants exhibiting poor propulsive forces and excessive braking, through different biomechanical mechanisms. These findings highlight the importance of considering individual A-P GRF patterns when prescribing orthotic interventions in post-stroke rehabilitation. |
| DOI | 10.1186/s12984-026-01876-0 |
| PMID | 41578343 |