In this study, we performed 6-minutes walking tests using a portable gas analyzer in patients with post-stroke hemiparesis, and examined the effects of ankle-foot orthosis (AFO) application on the walking ability and energy expenditure during walking. The subjects were 18 patients with post-stroke hemiparesis, who were admitted to the rehabilitation care unit of our rehabilitation center, and could walk. We performed 6-min walking tests with and without AFO application in these patients, and examined the walking distance and velocity, oxygen consumption (VO2), and heart rate (HR) during walking. The oxygen consumption per meter (VO2m −1 ) and physiological cost index (PCI) were determined as the efficiency of kinetic energy. The difference in the VO2 during walking was not significant between application and non-application of the AFO, but the differences in the walking distance and velocity and the VO2m −1 and PCI were significant. It was suggested that improvement of the walking ability and reduction of energy expenditure during walking were possible in motion-impaired patients with post-stroke hemiparesis by AFO application.

Background: Few reports have examined the relationship between balance ability and walking ability in people with transfemoral amputation using the Berg Balance Scale. Objectives: To assess the construct validity (known groups discrimination, convergent validity, and floor/ceiling effects) of Berg Balance Scale for people with transfemoral amputation. Study design: Cross-sectional study Methods: Thirty people with transfemoral amputation participated (age: 54 ± 19 years; range: 18–78 years). Outcome measures (Berg Balance Scale, Timed Up & Go test, Six-Minute Walk Test, and use of ambulatory aids) were compared between the groups requiring and not requiring ambulatory aids by the Mann–Whitney U test, Student’s t-test or Welch’s t-test. Correlations were assessed using Spearman’s rank correlation coefficients and age-corrected Spearman’s partial rank correlation coefficients. Results: The group using ambulatory aids had a significantly lower Berg Balance Scale score (41 ± 5 vs 52 ± 3). Berg Balance Scale score was correlated with Timed Up & Go test, use of aids, and Six-Minute Walk Test using Spearman’s rank correlation coefficients (r =−0.85, p < 0.0001; r =−0.82, p < 0.0001; r = 0.81, p < 0.0001) and age-corrected partial rank correlation coefficients (r =−0.66, p < 0.0001; r =−0.56, p = 0.0017; r = 0.57, p = 0.0012). No ceiling effect of Berg Balance Scale was observed. Conclusions: Balance ability in people with transfemoral amputation could be evaluated using Berg Balance Scale and is correlated with walking ability. Clinical relevance In clinical practice, using Berg Balance Scale for people with transfemoral amputation may adequately enable us to discriminate different groups based on walking ability from the perspective of balance ability. When walking ability is evaluated as low, the improvement of walking ability may be evaluated by Berg Balance Scale improvement during rehabilitation.

[Purpose] The purpose of this study was to investigate the relationship between the patellar movement and the standing backward leaning perceptibility. [Subjects and Methods] Fourteen volunteers who were confirmed presence of upward patellar movement during backward leaning from the quiet standing posture participated in this study. The quiet standing position, the standing backward leaning position at patellar movement onset and standing position perceptibility were measured. The position of the center of pressure in the anteroposterior direction in standing is represented as the percentage distance from the hindmost point of the heel in relation to the foot length (%FL). [Results] The mean value of the center of pressure on anteroposterior direction positions in quiet standing was 43.2%FL. The patellar movement onset position was 35.1%FL. The individual mean value of standard deviations for the onset position was 2.5%FL. The absolute error at the onset position is specifically and significantly small. [Conclusion] For the subjects whose patellas move during backward leaning in this study, the standing position near the onset position was perceived accurately, probably by the substantial change in sensory information associated with the onset of patellar movement while backward leaning.

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Background:The rate of indoor prosthetic use in people with lower limb amputation (LLA) is lower than that of outdoor use. Very few studies of indoor prosthetic use have been conducted, and no studies have focused on the perspective of instrumental activities of daily living (IADLs).Objectives:To assess the indoor prosthetic use of individuals with unilateral LLA from the perspective of IADLs.Study design:Cross-sectional study.Methods:A total of 162 people with LLA participated in this study. Based on the information obtained from a questionnaire and medical records, the relationships between each outcome and indoor prosthetic use were assessed by univariate analysis and multivariate logistic regression analysis.Results:Of the 110 respondents (72.8%), 6 participants did not use the prosthesis or used it for cosmesis. With respect to the prosthetic users (n = 104), 74 (71.2%) used their prosthesis indoors and outdoors and 30 (28.8%) used it only outdoors, but none used it indoors only. On univariate analysis, five items were identified: household size, amputation level, domestic chores and outdoor activities of the Frenchay Activities Index, and difficulty donning/doffing the prosthesis. Small household, transtibial amputation, and a high score on the domestic chores of the Frenchay Activities Index (cutoff value 9.0 points) were independently associated with indoor prosthetic use.Conclusions:Training of motions that are desirable to use the prosthesis and participation in domestic chores frequently based on IADLs before hospitalization may increase the frequency of prosthesis use in people with transfemoral amputation who use their prosthesis outdoors.

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