2024 Volume 3 Issue 2 Pages 98-110
Background and Purpose : We report a case of a severe hemiplegic patient with severe damage to the corticospinal and corticoreticular tracts, as confirmed by diffusion tensor imaging. Consistent with the outcome prediction performed using diffusion tensor imaging, the paresis did not show significant improvement. However, the patient achieved independent ambulation on all surfaces through alternate gait training using a knee-ankle-foot orthosis (KAFO).
Case Description : The patient was a 60-year-old male who suffered an ischemic stroke with severe motor paralysis of the right lower limb. He had difficulty in performing voluntary movements and exhibited severe instability on the affected side during the stance phase of walking, for which a knee-ankle-foot orthosis (KAFO) was prescribed.
Intervention: Alternate gait training was provided using a KAFO with ankle joint mobility to facilitate and induce lower limb muscle activity. As the patient’s walking ability improved, he was able to transition from a KAFO to an ankle-foot orthosis (AFO).
Outcomes : As indicated by the imaging findings of the corticospinal tract, severe motor paralysis persisted for four months after the onset. However, the patient achieved independent outdoor ambulation using an AFO and a single point cane, reaching a walking speed of 64.2 m/min. In addition, the patient successfully returned to work.
Conclusion : Providing alternate gait training using a KAFO and having the patient continue walking in such a way may have contributed to improvement in his walking ability.
