Comparison of gait between stroke patients and healthy volunteers using knee-ankle-foot orthoses with adjustable knee flexion.
Minoru Murayama
PMID 40034559WHAT IT FOUND
Stroke patients showed significantly greater knee flexion than healthy volunteers during mid-stance when using orthoses set to allow 30 degrees of movement or free motion.
This suggests these settings may cause excessive knee buckling in stroke recovery, potentially requiring stricter limitation.
Key findings
01During mid-stance, knee flexion angle was significantly greater in stroke patients than healthy volunteers under the 30-degree movement and free settings.
02In pre-swing and swing phases, knee flexion angle was significantly greater in healthy volunteers than stroke patients under the free setting.
03Stroke patients showed increased knee flexion during mid-stance compared with loading response under the 30-degree movement and free settings, suggesting excessive flexion.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample size was very small (8 participants per group), limiting statistical power and generalizability. Walking speed was not controlled, so differences in speed between the stroke patients and healthy volunteers may have influenced the knee angle results. There was a large age difference between the stroke patients (mean 59.3 years) and healthy volunteers (mean 21.4 years), which could affect gait mechanics independently of the orthosis setting. The study measured knee angles but did not measure actual muscle activity, so it cannot confirm if the observed flexion was due to weakness or other factors.
Declared interests
The authors declare no conflict of interest, and the research received no specific grant funding.
The easy way to misread this
Do not assume that adjustable KAFOs are superior to fixed ones for all stroke patients. The study found that settings allowing more knee motion (30 degrees and free) were associated with significantly greater knee flexion in stroke patients during mid-stance, which may indicate instability rather than improved function.