Authors (including presenting author) :
Tai HY (1), Chung PH (1), Lau FO (1)
Affiliation :
(1) Physiotherapy Department, Tai Po Hospital
Introduction :
Improve walking ability and endurance is one of the main goals of rehabilitation after patient stroked. However, for patients with poor motor control and exercise tolerance, manual assisted standing and gait training are challenging and labor-intensive. Evidences in clinical studies showed that using of external support such as knee-ankle-foot orthosis (KAFO) can promote active rehabilitation and facilitates quick recovery in stroke patients. It allowed patients to gain stability in the paralyzed foot and walk with better dynamic balance.
Objectives :
This study aims to review the effectiveness of using Knee-Ankle-Foot Orthosis (KAFO) in gait training among in-patient stroke patients of Tai Po Hospital since implementation on September 2019.
Methodology :
Total 58 patients admitted to Tai Po Hospital between 1st September 2019 to 30th September 2021 were screened by physiotherapists for KAFO training apart from traditional physiotherapy. Excluding patients transfer out or only received single session of KAFO, total 45 patients (27 males, 16 females, mean age 66.49) with subacute stroke (average day since stroke: 11.16) were included in the analysis. The average number of sessions of KAFO was 7.44. Walking distance during KAFO gait training, Modified Functional Ambulation Category (MFAC), Modified Rivermead Mobility Index (MRMI) and Berg’s Balance Scale (BBS) were used to measure the functional outcomes of stroke patients in terms of walking tolerance, ambulation, mobility and balance respectively.
Result & Outcome :
Patients who received KAFO training had significantly within-group improvement in MFAC, MRMI and BBS (p<0.001). The mean change of MFAC, MRMI and BBS were 0.53 (pre 1.91 vs post 2.44), 5.71 (pre 11.56 vs post 17.27) and 4.2 (pre 3.4 vs post 7.6) respectively. The walking distance also significantly improved (pre 2.82m vs post 20m, main change: 17.18m, p<0.001) in which 60% of patients improved from standing only to walking with KAFO and walking aids. The promising results showed that KAFO is effective in improving walking ability and tolerance of stroke patients. And KAFO continued to be one of the daily routine of physiotherapy training in in-patient rehabilitation of Tai Po Hospital.
