Effect on Gait of Ankle-Foot Orthoses Tuning in Stroke Rehabilitation
Research type
Research Study
Full title
Tuning of Ankle-Foot Orthoses for Early Stroke Rehabilitation: Does Real Time Kinematic and Spatiotemporal Feedback Make a Difference?
IRAS ID
206443
Contact name
Philip Rowe
Contact email
Sponsor organisation
University of Strathclyde
Duration of Study in the UK
0 years, 5 months, 13 days
Research summary
Orthoses are artificial external devices which support the limbs or spine and/or prevent or assist relative movement. Research has shown positive improvements in stroke-patients walking when wearing an ankle-foot-orthosis(AFO). The study aims to establish any benefits of tuning AFOs in stroke patients suffering from weakness on one side of the body. Tuning an AFO is making adjustments to the wedge underneath the AFO for biomechanical optimisation aiming to improve the characteristics of walking.
Current research has highlighted the positive effects of tuning AFOs for children with cerebral palsy. However, limited evidence supports tuning of AFOs specifically for early stroke patients. Furthermore, research suggests that failure to tune AFOs can cause immediate detrimental effects on function. Walking parameters will be measured in early post-stroke individuals in a number of walking trials comparing a tuned and un-tuned AFO to baseline (walking with shoes only) in an observational study.
Walking will be assessed using 3d optical motion capture. This technique uses retroreflective markers attached to the body that are tracked by infrared cameras. It utilises computer software to record the physical movements of people, capturing them and rendering a three-dimensional computer model that recreates the person’s movements, allowing for better analysis of complex motion. It does not record any image of the patient. Traditionally, extraction of data from motion capture files was a lengthy process, requiring biomechanical knowledge and training making it less suited to clinical use. This study will utilise novel software that provides real time kinematic data, such as joint/limb angles, and spatiotemporal feedback, such as walking speed and step symmetry, from the motion capture walking trials. This project will evaluate the use of novel software for walking analysis, commenting if real-time feedback could make a difference to tuning prescription of the AFO, thus improving the patient’s walking.Tuning of AFOs in NHS Lanarkshire relies on by eye analysis by clinician, dependent on the clinicians’ skill, experience and ability to describe movement errors to the patients. This study will compare walking analysis made by the clinician (by eye) and by 3d motion capture.
Data collected will be used to design a subsequent randomised controlled trial of 3d motion capture as a clinical tool for tuning AFOs, should the initial cohort studies indicate positive benefits of utilising the novel system to the patients and clinicians.REC name
South East Scotland REC 02
REC reference
16/SS/0104
Date of REC Opinion
2 Jun 2016
REC opinion
Further Information Favourable Opinion