Balance and Gait Patterns in Patients With Hemiplegia Wearing Anterior and Posterior Leaf Springs

편마비 환자에서 전방형과 후방형 플라스틱 단하지 보조기의 효과 비교

Asymmetrical stance posture, balance, and gait disturbance are common problems in hemiplegic patients. Posterior leaf springs (PLS) are frequently prescribed to correct these problems. Recently, anterior leaf springs (ALS) have also been prescribed, but only limited studies have been performed to investigate the effects of ALS. The purpose of this study was to compare the effects of three conditions, i.e., wearing an ALS, wearing a PLS, and not wearing an AFO (ankle foot orthosis),: on 1) the distribution of weight bearing on the affected side, 2) standing balance, and 3) the gait patterns of hemiplegic patients. Eleven hemiplegic patients (10 men and 1 woman) participated in this study. The data were analyzed by the Friedman test. The results were as follows: 1) More weight bearing on the affected leg was observed in the ALS and PLS conditions than in the condition without an AFO. No significant difference between the ALS and PLS conditions was found. 2) There were statistically significant differences in the composite equilibrium scores (CES) among the three conditions. The CES in the PLS condition was significantly higher than in the ALS condition or the condition without an AFO. 3) Gait patterns improved significantly in the ALS and PLS conditions. No statistically significant difference between the ALS and PLS conditions was found. These results suggest that both ALS and PLS effectively improve the distribution of weight bearing on the affected side, standing balance, and gait patterns of hemiplegic patients. Further study using three-dimensional kinematic analysis and dynamic electromyography is needed to support these findings.