Objective : The purpose of this study is to determine the effect of different knee joints in knee ankle foot orthosis on the availability of cut-down.

Methods : Subjects were first-episode stroke hemiplegics admitted to a rehabilitation ward between April 2015 and April 2021. 44 patients who were prescribed knee ankle foot orthosis were divided into two groups according to whether or not a cut-down was possible, and compared. A logistic regression analysis was conducted using the items that showed significant differences as independent variables and the availability of cut-down as the dependent variable.

Results : The logistic regression analysis for the possibility of cut-down revealed that the type of knee joint and cognitive FIM at admission were independent determinants of cut-down.

Conclusion : The results suggest that different types of knee joints and cognitive FIM at admission may influence whether cut-down is possible or not in hemiplegic patients with first stroke.

Objective : This research aimed to investigate independently the factors that influence gait, and cutoff values in patients with stroke who underwent gait training using WelWalk WW-1000 (WW). It is based on various assessments, including cognitive and attentional functions, from the time of admission to the recovery phase rehabilitation ward.

Methods : We included 113 patients with stroke who presented with a Functional Independence Measure (FIM) gait score 4 or below, and needed to use Knee-Ankle-Foot Orthosis (KAFO) for gait training. They underwent gait training using WW at least 10 times, and their communicative functions were sufficient. The assessment items to analyze were age, side of paralysis, Stroke Impairment Assessment Set (SIAS), FIM motor items, FIM cognitive items, Mini-Mental State Examination (MMSE), Catherine Bergego Scale, Trail Making Test Japanese version (TMT-J), and parameters calculated by WW. A binomial logistic regression analysis was conducted by dividing the participants into two groups depends on the final gait level at the time of discharge: the independent and non-independent group.

Results : The predictors were age (odds ratio: 0.880) and TMT-J part-A (odds ratio: 0.964). The cut off values were 68 years old in age, and 148 seconds in TMT-J part-A.

Conclusion : This study revealed that age, and cognitive and attentional functions are likely to be related to gait independently in patients with stroke using WW.

Objective : Definitive criteria for the need of a custom-made knee-ankle-foot orthosis (KAFO) have not yet been established. To contribute to the decision-making process of clinicians, we investigated the factors related to the decision regarding the necessity of a custom-made KAFO for patients with stroke.

Methods : A total of 249 acute stroke patients who required a KAFO for walking were divided into two groups according to whether they were prescribed a custom-made KAFO. A univariate analysis was used to compare the factors between the two groups. Logistic regression analysis was used to detect the factors related to the decision regarding the necessity of a custom-made KAFO.

Results : According to the logistic regression analysis, Brunnstrom stage of lower extremity, stability of the affected leg, tactile sensation of the affected leg, and Scale for Contraversive Pushing were determined to be related factors.

Conclusion : Prescription of a custom-made KAFO may be determined based on an overall assessment of lower limb function, stability of the affected lower limb, lower limb sensory disturbance, and severity of pushing behavior.

Purpose : The purpose of this study was to investigate whether providing alternate gait training using a knee-ankle-foot orthosis with an oil damper ankle hinge （KAFO-OD） results in therapeutic effects surpassing the outcomes predicted using previously reported prognostic method for ambulatory independence.

Methods : Forty-three stroke patients underwent alternate gait training using a KAFO-OD at a convalescent rehabilitation ward. We retrospectively investigated each patient’s predicted ambulatory independence level based on Niki’s independence prediction method, and compared them with the patient’s actual independence level at discharge.

Results : According to Niki's prediction indicators, three patients were predicted to achieve ambulatory independence, 28 were predicted to be dependent, and prediction was not possible for the remaining 12 patients. However, assessment at discharge showed that 27 patients achieved ambulatory independence, while 16 remained dependent.

Conclusion : Providing alternate gait training using a KAFO-OD for stroke patients may improve ambulatory independence levels at discharge.

Wearing a traditional baby carrier while doing chores or traveling is a physical burden to mothers causing stiff shoulders and back pain in addition to the emotional stress of childcare. A less burdensome baby carrier allowing a mother to carry a baby for longer periods of time is proposed. We investigated physical gait and subjective fatigue before and after 30 min of exercise while wearing novel baby carrier support straps to the left and right lumbar vertebrae, tightened lumbar belt, and shoulder straps. We found lower subjective fatigue, less vertical movement of the head and trunk during walking, and improved pelvic tilt. This may be attributed to the innovations in the new swaddling straps, which allow the child to maintain a stable position while wearing them, consequently reducing fatigue.

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.

We experienced a case of paraplegia due to spinal cord infarction, for which brace therapy was performed using a short leg orthosis. In this case, knee bending was observed due to excessive dorsiflexion during mid-stance due to muscle weakness in the right triceps sure muscle., who complained of fear of falling due to knee bending. Therefore, we prescribed the Walk on Trimable, which has a dorsiflexion braking function on the right side, and verified the effectiveness of the dorsiflexion braking function. The method used a three-dimensional motion analysis device. We measured barefoot walking at optimal and maximum effort speeds using Gait Solution Design and Walk on Trimable. The evaluation parameters used included the amount of forward movement of the point of application of the ground reaction force during the right stance phase and the maximum value of the plantar flexion moment of the right ankle joint. As a result, we found a significant increase in the amount of forward movement of the point of application of ground reaction force and the maximum value of the right ankle plantar flexion moment under the Walk on Trimable condition. This is thought to have contributed to an increase in the amount of forward movement of the point of reaction force application.