Immediate effect of lateral-wedged insole on stance and ambulation after stroke.
OBJECTIVE
To perform kinematic and kinetic analyses on the static standing and ambulation in subjects after stroke with and without wearing a 5-degree lateral-wedged insole.


METHODS
Ten hemiparetic individuals with unilateral stroke were recruited. Participants performed quiet stance and ambulation with no insole wedge, paretic side wedged, and nonparetic side wedged in a random order. The vertical ground reaction force and temporal-spatial parameters of gait were measured. Symmetry index was also calculated.


RESULTS
During quiet stance, the symmetry index of weight bearing improved significantly with nonparetic side-wedged (P < 0.017), but not with paretic side-wedged insoles. During ambulation, the symmetry indices of kinematic and kinetic measurements in the frontal plane were not significantly different among the three conditions. However, the contralateral knee abductor moment was significantly (P < 0.05) less than that of the nonparetic limb during nonparetic side-wedged ambulation. The ipsilateral hip and knee abductor moments were significantly (P < 0.05) less than the nonparetic limb during paretic side-wedged ambulation.


CONCLUSIONS
Application of nonparetic side wedge insole can improve stance symmetry and tends to reduce the paretic knee abductor load during ambulation. The effects of paretic side-wedged insole are different. The present results provide guidelines for the placement of wedges in the shoes of individuals after stroke.
Chen
Chien-Hsun
CH
Department of Physical Therapy, Lotung Pohai Hospital, Yilan, Taiwan.
Lin
Kwan-Hwa
KH
Lu
Tung-Wu
TW
Chai
Huei-Ming
HM
Chen
Hao-Ling
HL
Tang
Pei-Fang
PF
Hu
Ming-Hsia
MH
D000368:Aged; D001696:Biomechanical Phenomena; D018592:Cross-Over Studies; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation; D011187:Posture; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016138:Walking