Decreased energy cost and improved gait pattern using a new orthosis in persons with long-term stroke

Objective: To measure energy cost and gait analysis in persons with stroke with and without a newly developed orthosis. Design: Immediate and long-term (3wk) intervention (before-after trial). Setting: University medical center. Participants: Volunteer sample of 27 persons with long-term (range, 0.6-19y) hemiparetic stroke. Intervention: Three-week familiarization to the new walking aid. Main Outcome Measures: Energy cost (per distance walked), preferred walking speed (PWS), and step length. Energy cost was examined in all subjects while walking on a treadmill at 3 different velocities (PWS, PWS+30%, PWS-30%) during 3 different situations (without orthosis, with orthosis, after 3-wk orthosis familiarization). Spatiotemporal aspects of the gait pattern were examined using a 6-m instrumented walkway system. Results: Using the orthosis immediately decreased energy cost in persons with stroke during walking at the PWS (P <.001) and significantly increased walking speed (P <.005) and step length (P <.001). After 3 weeks of familiarization to the orthosis, energy cost at the PWS and at PWS + 30% showed further improvement in energy cost (P <.05). Conclusions: The newly developed orthosis immediately decreases energy cost and improves walking speed and step length in persons with long-term stroke. After only 3 weeks of orthosis familiarization, energy cost shows additional improvement.