Knee joint movement and muscle activity changes in stroke hemiplegic patients on continuous use of knee-ankle-foot orthosis with adjustable knee joint.
Minoru Murayama
PMID 33935355WHAT IT FOUND
Setting the knee joint of a KAFO to allow movement, rather than locking it, increased vastus medialis muscle activity during walking in stroke patients.
However, muscle activity did not change after one month of continuous use, and the study was too small to confirm clinical benefit.
Key findings
01Allowing knee joint movement in the orthosis significantly increased vastus medialis activity compared to locking the knee, particularly during loading response and mid-stance.
02Continuous use of the orthosis for one month did not result in significant changes in muscle activity levels.
03Only the Functional Independence Measure score showed a significant increase after one month; other clinical scores did not change significantly.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only eight participants, which limits the generalizability of the findings. The one-month duration may have been too short to detect changes in muscle activity or functional recovery. The analysis relied on two-dimensional gait data and electromyography, which are less objective than three-dimensional motion capture. Participants received concurrent physical, occupational, and speech therapy, so the specific contribution of the orthosis settings cannot be isolated from the overall rehabilitation program.
Declared interests
The authors declared no conflicts of interest, and the research received no specific funding.
The easy way to misread this
Do not conclude that the orthosis prevents muscle atrophy or improves function. The study showed immediate changes in muscle activation patterns when the knee was unlocked, but did not demonstrate that one month of use led to significant changes in muscle activity or functional outcomes compared to baseline.