Hip abductor control in walking following stroke -- the immediate effect of canes, taping and TheraTogs on gait.

摘要

OBJECTIVE: To confirm previous findings that hip abductor activity measured by electromyography (EMG) on the side contralateral to cane use is reduced during walking in stroke patients. To assess whether an orthosis (TheraTogs) or hip abductor taping increase hemiplegic hip abductor activity compared with activity during cane walking or while walking without aids. To investigate the effect of each condition on temporo-spatial gait parameters. DESIGN: Randomized, within-participant experimental study. SETTING: Gait laboratory. SUBJECTS: Thirteen patients following first unilateral stroke. INTERVENTION: Data collection over six gait cycles as subjects walked at self-selected speed during: baseline (without aids) and in randomized order with (1) hip abductor taping, (2) TheraTogs, (3) cane in non-hemiplegic hand. MAIN MEASURES: Peak EMG of gluteus medius and tensor fascia lata and temporo-spatial gait parameters. RESULTS: Cane use reduced EMG activity in gluteus medius from baseline by 21.86%. TheraTogs increased it by 16.47% (change cane use-TheraTogs P = 0.001, effect size = -0.5) and tape by 5.8% (change cane use-tape P = 0.001, effect size = -0.46). In tensor fascia lata cane use reduced EMG activity from baseline by 19.14%. TheraTogs also reduced EMG activity from baseline by 1.10% (change cane use-TheraTogs P = 0.009, effect size -0.37) and tape by 3% (not significant). Gait speed (m/s) at: baseline 0.44, cane use 0.45, tape 0.48, TheraTogs 0.49. CONCLUSION: Hip abductor taping and TheraTogs increase hemiplegic hip abductor activity and gait speed during walking compared with baseline and cane use.