title: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Université Victor Segalen Bordeaux 2, Handicap et Système Nerveux, Bordeaux, France. mathieu.de-seze@chu-bordeaux.fr
authors.forename: Mathieu-Panchoa
authors.initials: MP
authors.lastname: de Sèze
authors.forename: Clément
authors.initials: C
authors.lastname: Bonhomme
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Daviet
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Burguete
authors.forename: Hugues
authors.initials: H
authors.lastname: Machat
authors.forename: Marc
authors.initials: M
authors.lastname: Rousseaux
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Mazaux
mesh_terms: D000704:Analysis of Variance; D000842:Ankle / Q000503:physiopathology*; D004867:Equipment Design; D005260:Female; D005602:France; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D010865:Pilot Projects; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016138:Walking / Q000502:physiology