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Titre : | Replacing canes with an elasticated orthotic-garment in chronic stroke patients The influence on gait and balance. A series of N-of-1 trials (2020) |
Auteurs : | Clare C. Maguire ; Judith M. Sieben ; Nathanael Lutz ; Gisela Van der Wijden ; Heike Scheidhauer ; Roberta De Bie |
Type de document : | Article |
Dans : | Journal of Bodywork and Movement Therapies (Vol. 24, n° 4, October 2020) |
Note générale : | doi:10.1016/j.jbmt.2020.06.006 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Accident vasculaire cérébral (AVC) ; Cannes ; Équilibre postural ; Marche à pied ; Orthèses |
Résumé : |
Objective:
To investigate the effect of replacing canes with an elasticated orthotic-garment on balance and gait-function in chronic stroke survivors. Design: Experimental, N-of-1 series with a replicated, ABC design with randomised phase duration in a home setting. Participants: Four cane using chronic stroke survivors (P1-4). Interventions: Phase A (912 weeks) cane-walking as usual to establish baseline values; Phase B (916 weeks) intervention: orthotic-garment worn throughout the day with maximal cane-use reduction; Phase C (910 weeks) participant-determined follow-up: either no walking-aid, orthotic-garment or cane. Outcome measures: Primary: Functional-Gait-Assessment (FGA), Secondary: Trunk-sway during walking measured as Total-Angle-Area (TAA°2) in frontal and sagittal-planes, both measured weekly. Results: Visual and statistical analysis of results showed significant improvements in FGA from phase A to B in all participants. Improvement continued in phase C in P2, stabilized in P1 and P4 and deteriorated in P3. A Minimal-Clinical-Important-Difference of 6 points-change was achieved in P2 & P4. Trunk-sway reduced during walking, indicating increased stability, in two participants from phase A to B and in three participants from A to C but no TAA changes were statistically significant. In phase C participant-selected walking-aids were: P1 cane-usage reduced by 25%, P2 independent-walking with no assistive-device, S3 usual cane-usage, P4 orthotic-garment with reduced cane-usage 2-3 days-a-week, usual cane-usage 45 days. Conclusions: Although walking ability is multifactorial these results indicate that the choice of walking-aids can have a specific and clinically relevant impact on gait following stroke. Hands-free assistive-devices may be more effective than canes in improving gait-function in some patients. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S1360859220300851 |