Panacea Index Logo

Command Palette

Search for a command to run...

Replacing canes with an elasticated orthotic-garment in chronic stroke patients - The influence on gait and balance. A series of N-of-1 trials.

Journal of bodywork and movement therapies
October 1, 2020
Clare C Maguire et al. (6 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

To investigate whether replacing canes with an elasticated orthotic-garment improves balance and gait-function in chronic stroke survivors.

Results Summary

The study found significant improvements in Functional-Gait-Assessment (FGA) scores and reduced trunk-sway in some participants when using the orthotic-garment, indicating better stability. However, results varied by participant during follow-up, with some maintaining improvements, others stabilizing, and one deteriorating.

Population

Four chronic stroke survivors who previously used canes.

Effective Dosage

Orthotic-garment worn throughout the day with maximal cane-use reduction.

Duration

Phase A (9-12 weeks), Phase B (9-16 weeks), Phase C (9-10 weeks).

Interactions

None mentioned

Extracted Claims (15)
InterventionDirectionEndpointPopulationDosageImpactClaim #
replacing canes with an elasticated orthotic-garment
increase
Functional-Gait-Assessment (FGA)
cane using chronic stroke survivors
-
significant improvements
#1
replacing canes with an elasticated orthotic-garment
decrease
Trunk-sway during walking measured as Total-Angle-Area (TAA)
cane using chronic stroke survivors
-
reduced
#2
replacing canes with an elasticated orthotic-garment
increase
Trunk-sway during walking
cane using chronic stroke survivors
-
increased stability
#3
orthotic-garment worn throughout the day with maximal cane-use reduction
increase
Functional-Gait-Assessment (FGA)
P2
-
improvement continued
#4
orthotic-garment worn throughout the day with maximal cane-use reduction
no change
Functional-Gait-Assessment (FGA)
P1 and P4
-
stabilized
#5
orthotic-garment worn throughout the day with maximal cane-use reduction
decrease
Functional-Gait-Assessment (FGA)
P3
-
deteriorated
#6
orthotic-garment worn throughout the day with maximal cane-use reduction
increase
Minimal-Clinical-Important-Difference
P2 & P4
6 points-change
achieved
#7
orthotic-garment worn throughout the day with maximal cane-use reduction
decrease
Trunk-sway during walking
two participants
-
reduced
#8
orthotic-garment worn throughout the day with maximal cane-use reduction
decrease
Trunk-sway during walking
three participants
-
reduced
#9
orthotic-garment worn throughout the day with maximal cane-use reduction
no change
Total-Angle-Area (TAA)
cane using chronic stroke survivors
-
no changes were statistically significant
#10
participant-determined follow-up: either no walking-aid, orthotic-garment or cane
decrease
cane-usage
P1
25%
reduced
#11
participant-determined follow-up: either no walking-aid, orthotic-garment or cane
decrease
walking-aid usage
P2
-
independent-walking with no assistive-device
#12
participant-determined follow-up: either no walking-aid, orthotic-garment or cane
no change
walking-aid usage
S3
-
usual cane-usage
#13
participant-determined follow-up: either no walking-aid, orthotic-garment or cane
decrease
walking-aid usage
P4
2-3 days-a-week
orthotic-garment with reduced cane-usage
#14
participant-determined follow-up: either no walking-aid, orthotic-garment or cane
no change
walking-aid usage
P4
4-5 days
usual cane-usage
#15
Abstract

OBJECTIVE: To investigate the effect of replacing canes with an elasticated orthotic-garment on balance and gait-function in chronic stroke survivors. DESIGN: Experimental, N-of-1 series with a replicated, ABC design with randomised phase duration in a home setting. PARTICIPANTS: Four cane using chronic stroke survivors (P1-4). INTERVENTIONS: Phase A (9-12 weeks) cane-walking "as usual" to establish baseline values; Phase B (9-16 weeks) intervention: orthotic-garment worn throughout the day with maximal cane-use reduction; Phase C (9-10 weeks) participant-determined follow-up: either no walking-aid, orthotic-garment or cane. OUTCOME MEASURES: Primary: Functional-Gait-Assessment (FGA), Secondary: Trunk-sway during walking measured as Total-Angle-Area (TAA° RESULTS: Visual and statistical analysis of results showed significant improvements in FGA from phase A to B in all participants. Improvement continued in phase C in P2, stabilized in P1 and P4 and deteriorated in P3. A Minimal-Clinical-Important-Difference of 6 points-change was achieved in P2 & P4. Trunk-sway reduced during walking, indicating increased stability, in two participants from phase A to B and in three participants from A to C but no TAA changes were statistically significant. In phase C participant-selected walking-aids were: P1 cane-usage reduced by 25%, P2 independent-walking with no assistive-device, S3 usual cane-usage, P4 orthotic-garment with reduced cane-usage 2-3 days-a-week, usual cane-usage 4-5 days. CONCLUSIONS: Although walking ability is multifactorial these results indicate that the choice of walking-aids can have a specific and clinically relevant impact on gait following stroke. "Hands-free" assistive-devices may be more effective than canes in improving gait-function in some patients. CLINICALTRIALS. GOV ID: NCT03642444.

Medical Subject Headings (MeSH)
CanesClothingGaitHumansPostural BalanceStrokeStroke RehabilitationWalking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality68/10
Citation Metrics
Total Citations3
Citations/Year0.6
Relative Citation Ratio0.38
NIH Percentile20.5%
Research Impact Scores
APT Score0.25
Weight Score1.93
Normalized Score0.64
Related Supplements