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Effect of early compensation of distal motor deficiency by the Chignon ankle-foot orthosis on gait in hemiplegic patients: a randomized pilot study.

Abstract : Objective: To compare the effect of the Chignon ankle-foot orthosis on gait versus a standard ankle-foot orthosis. Method: A multicentre randomized study was conducted in seven rehabilitation centres. Hemiplegic patients were recruited after unilateral stroke lasting less than six months. Exclusion criteria were: impossibility to stand for 10 seconds; ankle passive dorsiflexion <5 degrees with knee flexed to 90 degrees; triceps spasticity ≥3/4 on the Ashworth modified scale; diseases that might impair active participation in the study. Thirteen patients were randomized to the Chignon group and 15 to the control group. Included patients were given a standard ankle-foot orthosis or Chignon ankle-foot orthosis. The Chignon ankle-foot orthosis is an articulated double-stopped custom-made orthosis with elements to assist dorsiflexion and plantar flexion. Gait speed improvement (ten-metre test), kinematic assessment, and functional scales were assessed. Results: Gain ratio of walking speed with the orthosis increased significantly more in the Chignon group than in the control group at day 0 (27.2 ± 36% versus -0.8 ± 17%; P = 0.006), day 30 (39.9 ± 19% versus 7.5 ± 17%; P = 0.0004) and day 90 (44.6 ± 27% versus 17.1 ± 0.3%; P = 0.04). There was also a significant improvement in kinematic parameters and spasticity in the Chignon group. CONCLUSION: Early compensation of distal motor deficiency by the Chignon ankle-foot orthosis improves the immediate gait of hemiplegics more than the standard ankle-foot orthosis and seems to modify motor recovery processes in the legs after stroke.
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https://hal-unilim.archives-ouvertes.fr/hal-00627209
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Submitted on : Wednesday, September 28, 2011 - 10:16:30 AM
Last modification on : Friday, May 20, 2022 - 3:41:27 AM

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Mathieu-Panchoa de Sèze, Clément Bonhomme, Jean-Christophe Daviet, Emmanuel Burguete, Hugues Machat, et al.. Effect of early compensation of distal motor deficiency by the Chignon ankle-foot orthosis on gait in hemiplegic patients: a randomized pilot study.. Clinical Rehabilitation, SAGE Publications, 2011, epub ahead of print. ⟨10.1177/0269215511410730⟩. ⟨hal-00627209⟩

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