소아마비에서 4절 연쇄 장하지보조기 사례연구

The purpose of this study was to compare the ring lock type knee-ankle-foot orthosis (KAFO) with newly developed 4-bar linkage KAFO on the gait characteristics of persons with poliomyelitis clinically. This 4-bar linkage is the stance control type KAFO which provide the stability during stance phase and knee flexion during swing phase. Two subjects participated in this study voluntarily. We provided the customized 4-bar linkage KAFO then asked the subjects to walk in level surface and stairs under the two different KAFO conditions. The characteristics of gait in the persons with poliomyelitis were evaluated using a 3D motion analysis system and force plate. Additionally 6 minute walk test for physiological cost index were conducted using pulse oximeter to measure the energy consumption. In the results of this study, the differences of 4-bar linkage KAFO compared with ring lock type KAFO are as follows: (1) Walking speed, stride length, and step length on level increased in subjects, (2) The gait symmetry was improved by generated knee flexion and decreased pelvic external rotation on level and stairs walking, (3) Decreased vertical excursion of center of mass and pelvic elevation during swing phase was decreased on level, (4) Knee extension moment, hip flexion moment, hip and knee internal rotation moment of non-braced limb were decreased on level walking, (5) Walking speed in 6-minute walk test was increased and physiological cost index was decreased. These findings indicate that 4-bar linkage KAFO compared with ring lock type KAFO is effective in enhancing pattern, endurance, and energy consumption in level surface and stairs walking.