The effect of early construction of a knee-ankle-foot-orthosis during the acute phase in severe hemiplegic patients for functional independence measure of walking and stair climbing

Abstract

We studied the effects of physical therapy with an early prescription of a knee-ankle-foot-orthosis (KAFO) on the time course of recovery of walking and stair climbing functions by using functional independence measures (FIM) in hemiplegic patients due to stroke or brain injury. We retrospectively recruited 8 patients with hemiplegia who had been prescribed a KAFO during an acute hospital stay (the KAFO group), and 20 patients who had not been prescribed a KAFO (the non-KAFO group), who were admitted with stroke at the author’/s hospital between June 2010 and May 2013. All patients in the non-KAFO group had characteristics similar to those of the KAFO group during admission : age, length of hospitalization, severity of hemiplegia, the day of admission to the Kaifukuki (convalescent)-rehabilitation ward from stroke onset, walking function, and stair climbing function. We compared the time course of recovery of walking and stair climbing functions between the KAFO and non-KAFO groups by using FIM at admission, mid-duration of the hospital stay, and discharge, from the Kaifukuki-rehabilitation ward. FIM for walking and stair climbing improved progressively in both groups. However, walking function improved earlier in the KAFO group than in the non-KAFO group. Furthermore, the stair climbing function at discharge was significantly better in the KAFO group than in the non-KAFO group. Physical therapy using an early-prescribed KAFO may be effective for improving walking and stair climbing function in post-stroke patients with severe hemiplegia.