Effects of toe spreader on plantar pressure and gait in chronic stroke patients

Impact of Sex and Velocity on Plantar Pressure Distribution during Gait: A Cross-Sectional Study Using an Instrumented Pressure-Sensitive Walkway

In-shoe systems and pressure plates are used to assess plantar pressure during gait, but additional tools are employed to evaluate other gait parameters. The GAITRite® system is a clinical gait evaluation tool. Extensive literature is available for spatiotemporal parameters, but it is scarce for relative plantar pressure data. Therefore, we investigated whether, when controlling for age, the GAITRite® system is able to distinguish the effects of walking velocity on plantar pressure parameters in six plantar regions in a large sample of adults. Participants (83 women and 87 men, aged 18−85 years) walked at three self-selected velocities (slow, preferred, fast) on a 6-m long GAITRite® walkway. Relative peak pressure, pressure-time integral, peak time and contact area were computed for six zones (lateral and medial heel, mid- and forefoot). The impact of age (covariate), sex, side, velocity, pressure zone and their interactions on pressure variables was evaluated. Velocity affected peak pressure, pressure-time integral, peak time and contact area (p < 0.001). With increasing self-selected gait velocity, medial forefoot peak pressure and pressure-time integral increased (p < 0.001), while heel and lateral forefoot regions displayed a nonlinear plantar pressure evolution. These results suggest lower (heel strike) or more equally distributed (push-off) loads at preferred gait velocity.

Exercise Prescription Improve the Rehabilitation of a Child With Viral Encephalitis Sequelae: A Case Report

This study conducted a personalized exercise prescription intervention on a child with viral encephalitis sequelae (VES). The purpose was to observe the rehabilitation process from the aspects of brain activation, and the curative effects on balance function and gait. A further aim was to explore the possible nerve biomechanical mechanisms between the extent of brain activation and the improvement in balance function and gait. A 12-week exercise prescription was used as the treatment method, and functional near-infrared spectroscopy (fNIRS), balance function test system, plantar pressure distribution system, and 3D gait system were used to assess the effects of the rehabilitation process pre and post the intervention. Following the exercise prescription intervention: (1) fNIRS showed that brain activation in the S1-D1, S1-D2, S1-D3, S2-D1, S3-D2, S3-D3, S4-D3, S5-D5, S5-D6, S5-D7, S7-D6, S7-D7, S8-D7, and S8-D8 increased significantly (P < 0.05). (2) The balance test showed that the area of motion ellipse and movement length of the child with eyes open decreased significantly and area of motion ellipse, back and forth swing, left and right swing and movement length of the child with eyes closed all decreased significantly (P < 0.05). (3) The static plantar pressure distribution demonstrated that the pressure center of the left and right foot decreased significantly (P < 0.05) from 5.3° dislocation in a straight line in the sagittal plane to 1°; an increment of the pressure loading was found on the forefoot of both feet compared with what was recorded in the pre-test. (4) The testing results of the 3D gait system showed that she had a shortened time of unilateral support phase and prolonged swing phase on the affected leg (P < 0.05), compared to that of the non-affected leg. Furthermore, the dual support phase had also been prolonged (P < 0.05). Conclusion: 12 weeks' individualized exercise training can enhance the activation in the motor areas and improve balance function and gait in a child with VES.

Dynamic biomechanical effect of lower body positive pressure treadmill training for hemiplegic gait rehabilitation after stroke: A case report

BACKGROUND

Lower body positive pressure (LBPP) treadmill has potential applications for improving the gait of patients after stroke, but the related mechanism remains unclear.

CASE SUMMARY

A 62-year-old male patient suffered from ischemic stroke with hemiplegic gait. He was referred to our hospital because of a complaint of left limb weakness for 2 years. The LBPP training was performed one session per day and six times per week for 2 wk. The dynamic plantar pressure analysis was taken every 2 d. Meanwhile, three-digital gait analysis and synchronous electromyography as well as clinical assessments were taken before and after LBPP intervention and at the 4-wk follow-up. During LBPP training, our patient not only improved his lower limb muscle strength and walking speed, but more importantly, the symmetry index of various biomechanical indicators improved. Moreover, the patient’s planter pressure transferring from the heel area to toe area among the LBPP training process and the symmetry of lower body biomechanical parameters improved.

CONCLUSION

In this study, we documented a dynamic improvement of gait performance in a stroke patient under LBPP training, which included lower limb muscle strength, walking speed, and symmetry of lower limb biomechanics. Our study provides some crucial clues about the potential dynamic mechanism for LBPP training on gait and balance improvement, which is related to rebuilding foot pressure distribution and remodeling symmetry of biomechanics of the lower limb.