Original Research Article
Year: 2021 | Month: July | Volume: 11 | Issue: 7 | Pages: 69-80
DOI: https://doi.org/10.52403/ijhsr.20210711
Comparative Impact Study between Two Different Orthotic Clinical Approaches of Shank Vertical Angle Alignment on GRF Vectors and Activation Profile of Tibialis Anterior in Subjects with Post Stroke Hemiplegic using Solid Ankle Foot Orthosis: A Prospective Study
Shaliny Bandyopadhyay1, Hasan Md. Arif Raihan1, Harsh Kumar Kanhaiya1, Prasanna Lenka1
1Department of Prosthetics and Orthotics, National Institute for Locomotor Disabilities (Divyangjan) / The West Bengal University of Heath Sciences, B.T. Road, Bon-Hooghly, Kolkata-700090, Kolkata, India
Corresponding Author: Hasan Md. Arif Raihan
ABSTRACT
Background: Stroke is defined as the sudden onset of a focal neurologic deficit due to a presumed local disturbance in the blood supply to the brain. Orthotic treatment protocol in post stroke hemiplegic patients still is controversial topic. Numerous previous studies are concentrated upon providing the posterior heel wedge in outer side mainly with footwear’s heel rising associated with molded Solid Ankle Foot Orthosis (SAFO) but this is an attempt of this study to check the effects of insole posterior heel wedge as well as outsole posterior heel wedge in SAFO on temporal and kinetic gait parameters and activation profile of tibialis anterior muscle in post stroke hemiplegic patients.
Aim & Objectives: The aim of the study was to compare between insole and outsole posterior heel wedge in molded solid ankle foot orthosis on working efficiency and activation profile of tibialis anterior muscle of the subject with post stroke hemiplegia.
Materials and Methods: 30 subjects with post stroke hemiplegia were included in this study by convenient sampling method. The subjects were given with solid ankle foot orthosis with insole and outsole posterior heel wedge. The temporal and kinetic gait parameters and EMG of T.A muscle was measured using eWalk-NILD (MAT), Force plate and AD instrument power Lab. All the measurements were acquired at the time of measurement (Baseline data), time of discharge (Pre data) and after 4 weeks Post data was taken.
Results: Pre-post conditions GRF Fx,Fy,Fz have significantly differences. Some parameters also have the non-significant differences. For all the cases to assist the parameters pre and post condition associated with and without AFO with insole posterior heel wedges on Group A and outsole Posterior heel wedge on Group B values are respected for GRF Fx pre without AFO (p= .147), pre with AFO (p= .037) and post without AFO (p= .253) with AFO (p=.009) For Fy pre without and with AFO (p=.025), (p =.682), post without and with AFO (p= .000), (p= .524) in case of Fz pre without and with AFO (p= .759) , (p= .999) post without and with AFO (p=.117), (p=.404 ). On TA muscle profile have also significant differences between two groups on pre without and with AFO (p=.005), (p= .613) and post without and with AFO (p= .000), (p= .000).
Discussion & Conclusion: As per present perspective clinical evident report it is concluded that molded SAFO with outsole posterior heel wedge have a significance impact for positive influences on GRF, without any deficit contraction ( EMG signal) of T.A. muscle profile, as compare to insole posterior wedge with AFO.
Key words: Hemiplegic, Gait kinetic parameters, Molded ankle foot orthosis, Insole and Outsole Posterior Heel Wedge.