A study of the effectiveness of a leg splint during walking

  • Research type

    Research Study

  • Full title

    An investigation into mechanical and biomechanical effects of using solid Ankle Foot Orthoses in stroke patients during walking

  • IRAS ID

    240196

  • Contact name

    Amneh Alshawabka

  • Contact email

    amneh.alshawabka.2016@strath.ac.uk

  • Duration of Study in the UK

    1 years, 2 months, 17 days

  • Research summary

    Research Summary

    Improving walking ability for patients with a dropped foot is one of the top priorities of stroke rehabilitation. The use of a lower leg splint (Ankle-Foot Orthosis) aims to restore independent walking ability and to reduce energy expenditure. The purpose of this study is to investigate the mechanical and the biomechanical contributions of the splint to the ankle load (moment) during walking.
    In total, 20 stroke participants will be recruited in this study. In order to recruit the highest possible numbers of stroke participants, the recruitment will be promoted through a range of channels; from Greater Glasgow and Clyde and Lanarkshire Health Boards once the NHS ethical approval has been obtained, and from private orthotics and physiotherapy clinics where University Ethics Committee has already given approval (UEC18/28). In addition, the Departmental Ethics Committee has been obtained (DEC/BioMed/2018/240) to recruit a control group of 5 healthy participants for comparison.
    Participants will be invited to attend three sessions of no longer than 2 hours each at the National Centre for Prosthetics and Orthotics at the University of Strathclyde.
    The first session will be a screening session to determine whether the participant can be included in the study; if so, a plaster of Paris cast of the participant’s lower leg will be taken, following which the splint will be fabricated for each participant.
    The second session (one week later) will be to check the splint fitting, comfort, and function. Strain gauges, which are load sensors, will be then attached to the splint.
    The third session (two weeks later) will be to record the participant’s walking on a treadmill. Three conditions will be investigated: (1) walking with shoe only (2) walking with shoe and a lower leg splint (3) walking with shoe and a lower leg splint and a heel wedge. Reflective markers and electrodes placed on the participant’s lower limbs will be used to record lower limb movements and activity of the knee muscles, respectively. Force plates in the treadmill will be used to record the forces during the test. Movement and force data will be analysed to see if any differences exist between the tested conditions and to demonstrate which condition gives the most natural movement.

    Summary of Results

    This study aimed to understand the effects of using a custom-made leg splint on walking in stroke patients. Despite not recruiting any participants through the NHS, the study enrolled a total of six stroke patients (2 females, 4 males) and six healthy participants (3 females, 3 males) through other channels. Each participant wore the leg splint during walking analysis conducted on an instrumented treadmill and 3-dimensional motion analysis system.

    The study compared walking with standard shoes only, walking with the leg splint and standard shoes, and walking with an aligned leg splint. The results showed that using the aligned leg splint immediately improved walking speed, knee, and hip motion. Additionally, the activity of the anterior thigh muscles significantly increased while the activity of the posterior thigh muscles decreased compared to walking with standard shoes.

  • REC name

    West of Scotland REC 3

  • REC reference

    18/WS/0178

  • Date of REC Opinion

    12 Nov 2018

  • REC opinion

    Further Information Favourable Opinion