Gait improvement of hemiplegic patients using an ankle-foot orthosis with assistance of heel rocker function.

The ankle-foot orthosis (AFO) with oil damper, GaitSolution (GS), was previously developed to make heel rocker function possible during the gait of hemiplegic patients. To clarify the characteristics of patients who show adaptation to GS use, a questionnaire was completed by the clinicians responsible for 99 patients with hemiplegia who participated in this study. Clinicians completed items concerning gait data of patients without AFO use and with GS use, adaptation to the use of GS, and patient opinion of GS use. Approximately 60% of patients achieved heel rocker function during the loading response of the paretic limb and improved gait when using GS. A comparison of the patients whose gaits were improved by GS more than by other AFOs revealed the use of GS was well suited to the gait of patients with a relatively higher Brunnstrom stage and a slightly flexed knee joint during the stance phase. Approximately 60% of patients reported feeling comfortable using GS, although patient comfort did not necessarily coincide with the results of gait assessment by clinicians. Patient comfort mainly depended on trunk posture and hip joint outward rotation; hip joint outward rotation could be improved using GS in the recovery phase but not in the maintenance phase. This result implies the importance of gait training in the early stage of rehabilitation.