Trends and Technologies in Rehabilitation of Foot Drop: A Systematic Review

Alnajjar, Fady; Zaier, Riadh; Khalid, Sumayya; Gochoo, Munkhjargal

doi:10.1080/17434440.2021.1857729

Cited by 31 publications

(17 citation statements)

References 87 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It may be that inherent features of the device limit a full dorsiflexion effect during fast walking, leading patients to walk slower in order to obtain the full effect of the device. This may reflect a limitation of the device, as it lacks a closed loop control system that would allow for adaptation to different walking speeds [ 40 ]. On the other hand, it may encourage patients to adopt a slower and more controlled gait pattern, even in the DF-FES off state.…”

Section: Discussionmentioning

confidence: 99%

Functional Benefit and Orthotic Effect of Dorsiflexion-FES in Children with Hemiplegic Cerebral Palsy

et al. 2023

View full text Add to dashboard Cite

Functional electrical stimulation of the ankle dorsiflexor (DF-FES) may have advantages over ankle foot orthoses (AFOs) in managing pediatric cerebral palsy (CP). This study assessed the functional benefit and orthotic effect of DF-FES in children with hemiplegic CP. We conducted an open-label prospective study on children with hemiplegic CP ≥ 6 years who used DF-FES for five months. The functional benefit was assessed by repeated motor function tests and the measurement of ankle biomechanical parameters. Kinematic and spatiotemporal parameters were assessed by gait analysis after one and five months. The orthotic effect was defined by dorsiflexion ≥ 0° with DF-FES at either the mid or terminal swing. Among 26 eligible patients, 15 (median age 8.2 years, range 6–15.6) completed the study. After five months of DF-FES use, the results on the Community Balance and Mobility Scale improved, and the distance in the Six-Minute Walk Test decreased (six-point median difference, 95% CI (1.89, 8.1), –30 m, 95% CI (−83.67, −2.6), respectively, p < 0.05) compared to baseline. No significant changes were seen in biomechanical and kinematic parameters. Twelve patients (80%) who showed an orthotic effect at the final gait analysis experienced more supported walking over time, with a trend toward slower walking. We conclude that the continuous use of DF–FES increases postural control and may cause slower but more controlled gait.

show abstract

Section: Discussionmentioning

confidence: 99%

Functional Benefit and Orthotic Effect of Dorsiflexion-FES in Children with Hemiplegic Cerebral Palsy

et al. 2023

View full text Add to dashboard Cite

show abstract

“…For gait practice, FES stimulators with foot switches or finger switches could work well. There is a need for FES stimulators that can be more versatile in stimulus activation methods and timing flexibility [70,71].…”

Section: Advantages Of the Combined Interventionsmentioning

confidence: 99%

Necessity and Content of Swing Phase Gait Coordination Training Post Stroke; A Case Report

McCabe¹,

Roenigk²,

Daly

2021

Brain Sciences

View full text Add to dashboard Cite

Background/Problem: Standard neurorehabilitation and gait training has not proved effective in restoring normal gait coordination for many stroke survivors. Rather, persistent gait dyscoordination occurs, with associated poor function, and progressively deteriorating quality of life. One difficulty is the array of symptoms exhibited by stroke survivors with gait deficits. Some researchers have addressed lower limb weakness following stroke with exercises designed to strengthen muscles, with the expectation of improving gait. However, gait dyscoordination in many stroke survivors appears to result from more than straightforward muscle weakness. Purpose: Thus, the purpose of this case study is to report results of long-duration gait coordination training in an individual with initial good strength, but poor gait swing phase hip/knee and ankle coordination. Methods: Mr. X was enrolled at >6 months after a left hemisphere ischemic stroke. Gait deficits included a ‘stiff-legged gait’ characterized by the absence of hip and knee flexion during right mid-swing, despite the fact that he showed good initial strength in right lower limb quadriceps, hamstrings, and ankle dorsiflexors. Treatment was provided 4 times/week for 1.5 h, for 12 weeks. The combined treatment included the following: motor learning exercises designed for coordination training of the lower limb; functional electrical stimulation (FES) assisted practice; weight-supported coordination practice; and over-ground and treadmill walking. The FES was used as an adjunct to enhance muscle response during motor learning and prior to volitional recovery of motor control. Weight-supported treadmill training was administered to titrate weight and pressure applied at the joints and to the plantar foot surface during stance phase and pre-swing phase of the involved limb. Later in the protocol, treadmill training was administered to improve speed of movement during the gait cycle. Response to treatment was assessed through an array of impairment, functional mobility, and life role participation measures. Results: At post-treatment, Mr. X exhibited some recovery of hip, knee, and ankle coordination during swing phase according to kinematic measures, and the stiff-legged gait was resolved. Muscle strength measures remained essentially constant throughout the study. The modified Ashworth scale showed improved knee extensor tone from baseline of 1 to normal (0) at post-treatment. Gait coordination overall improved by 12 points according to the Gait Assessment and Intervention Tool, Six Minute Walk Test improved by 532′, and the Stroke Impact Scale improved by 12 points, including changes in daily activities; mobility; and meaningful activities. Discussion: Through the combined use of motor learning exercises, FES, weight-support, and treadmill training, coordination of the right lower limb improved sufficiently to exhibit a more normal swing phase, reducing the probability of falls, and subsequent downwardly spiraling dysfunction. The recovery of lower limb coordination during swing phase illustrates what is possible when strength is sufficient and when coordination training is targeted in a carefully titrated, highly incrementalized manner. Conclusions/Contribution to the Field: This case study contributes to the literature in several ways: (1) illustrates combined interventions for gait training and response to treatment; (2) provides supporting case evidence of relationships among knee flexion coordination, swing phase coordination, functional mobility, and quality of life; (3) illustrates that strength is necessary, but not sufficient to restore coordinated gait swing phase after stroke in some stroke survivors; and (4) provides details regarding coordination training and progression of gait training treatment for stroke survivors.

show abstract

“…The ankle joint is also one of the most vulnerable joints in the human body, there are two main causes for its injury: one is the joint sprain caused by external force in daily life, and the other is the ankle function injury caused by neurological diseases, such as stroke, spinal cord injury and other diseases [2,3]. There are about 15 million people worldwide who suffer from stroke every year [4], including 795000 stroke patients in the United States every year. According to the prediction by the American Heart Association, the number of stroke patients will rise to 3.4 million by 2030 [5].…”

Section: Introductionmentioning

confidence: 99%

Configuration Design and Kinematic Performance Analysis of a Novel 4-DOF Parallel Ankle Rehabilitation Mechanism with Two Virtual Motion Centers

Song

Wei

et al. 2023

Preprint

View full text Add to dashboard Cite

Aiming at the problem that the existing ankle rehabilitation robot is difficult to fully fit the complex motion of human ankle joint and has poor human-machine motion compatibility, a equivalent series mechanism model which is highly matched with the actual bone structure of the human ankle joint is proposed and mapped into a parallel rehabilitation mechanism. And the parallel rehabilitation mechanism has two virtual motion centers(VMCs), which can simulate the complex motion of the ankle joint, adapt to the individual differences of various patients, and can meet the rehabilitation needs of both left and right feet of patients. Firstly, based on the motion properties and physiological structure of the human ankle joint, the mapping relationship between the rehabilitation mechanism and ankle joint is determined, and the series equivalent model of the ankle joint is established. According to the kinematic and constraint properties of the ankle equivalent model, the configuration design of the parallel ankle rehabilitation robot is carried out. Secondly, according to the intersecting motion planes theory, the full-cycle mobility of the mechanism is proved, and the continuous axis of the mechanism is judged based on the constraint power and its derivative. Then, the kinematics of the parallel ankle rehabilitation robot is analyzed. Finally, based on the OpenSim biomechanical software, a human-machine coupling rehabilitation simulation model is established to evaluate the rehabilitation effect, which lay the foundation for the formulation of a rehabilitation strategy for the later prototype.

show abstract

Trends and Technologies in Rehabilitation of Foot Drop: A Systematic Review

Cited by 31 publications

References 87 publications

Functional Benefit and Orthotic Effect of Dorsiflexion-FES in Children with Hemiplegic Cerebral Palsy

Functional Benefit and Orthotic Effect of Dorsiflexion-FES in Children with Hemiplegic Cerebral Palsy

Necessity and Content of Swing Phase Gait Coordination Training Post Stroke; A Case Report

Configuration Design and Kinematic Performance Analysis of a Novel 4-DOF Parallel Ankle Rehabilitation Mechanism with Two Virtual Motion Centers

Contact Info

Product

Resources

About