
Abstract - Hemiparetic gait
is characterised by slow speed and poorly co-ordinated movements. Because the
values of gait parameters vary with changes in speed, the slow speed that is
typical of hemiparetic gait necessitates applying controls for the influence
of speed when comparing hemiparetic and able-bodied persons. Gait kinetics and
kinematics were measured in seven hemiparetic and seven able-bodied patients
to compare their gait patterns at similar speeds and to assess the effectiveness
of ankle-foot orthoses which were double-stopped in 5° of dorsiflexion or
5° of plantarflexion. Hemiparetic persons ambulating without the orthoses
had a shorter step length, longer duration stance and shorter duration swing
than normal. They displayed greater than normal flexion of the affected hip
during midstance, which, by putting the centre of mass farther in front of the
knee, may explain the increased knee extension moment due to vertical force.
Affected hip adduction during single support was less in hemiparetic persons
than in able-bodied persons, indicating a decreased lateral shift to the paretic
side. During the swing phase, the affected limbs of hemiparetic persons were
in less knee flexion and less dorsiflexion than normal, necessitating circumduction
to achieve toe clearance. Ankle-foot orthoses increased walking speed to normalise
heelstrike duration through use of an optimally adjusted plantarflexion stop.
An improperly adjusted orthosis may produce an exaggerated knee flexion moment
resulting in knee instability.