Development and evaluation of an energy storing shoe-insert for post-stroke individuals

Abstract

Many of post-stroke individuals have lost their forefoot rocker function during gait. The purpose of this study was to develop and evaluate a device (ROSI : Reverse Omega Shoe Insert) which could assisted forefoot rocker function during single stance of the paretic limb. The ROSI used in this study has an inverted omega shape made of carbon plates, and its apex is placed proximal to the Metatarsal pharangial (MP) joint. Sixteen ROSI patterns were fabricated according to an orthogonal table array, and the optimum shapes and positions of the ROSI were determined based on measurements of a healthy subject wearing a mimic trans femoral prosthesis. To confirm the validity of this ROSI, gaits of 16 patients were measured by a three-dimensional motion analysis system under two conditions, with the ROSI and an ankle foot orthosis under two conditions of the ROSI ancle foot orthosis with and without the dorsiflexion resistance. Results showed that the center of pressure moved more forward in the condition with ROSI and an AFO with dorsiflexion resistance. It was also found that the center of pressure moved distally beyond the ROSI axis, which was located proximal to the MP joint in this condition. This meant that the ROSI and AFO with dorsiflexion resistance facilitated the heel rise in a single stance of the paretic limb during gait of post-stroke individuals.