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Heel lift improves walking ability of persons with traumatic cauda equina syndrome-a pilot experimental study
Akhil John Kurien1, Thangavelu Senthilvelkumar2, Jacob George1
1Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, Tamil Nadu, India.
Study Design:
Non-randomized within-subject experimental study.
Objective:
To determine whether the addition of the 1 cm heel lift to the footwear improves the walking ability of the persons with Cauda Equina Syndrome (CES).
Setting:
Department of Physical Medicine and Rehabilitation, Christian Medical College, India.
Methods:
Fourteen people with bilateral plantar flexor weakness following traumatic CES (mean age 43.7 years) were recruited for the study. Their walking speed, stride length, cadence, and time taken to complete Timed Up and Go (TUG) were measured using footwear with back straps. Then, the 1 cm heel lift was attached to the sole of the footwear. After sufficient practice, all the parameters were reassessed to find out the effectiveness of the heel lift.
Results:
With the 1 cm heel lift, the participants walked 0.13 m/s (95% CI, 0.08-0.17) faster than their regular footwear. They were able to complete the TUG test 2.6 s (95% CI, 1.4-3.7) earlier than before. There was an increase of 5.2 in. in stride length (95% CI, 2.9-9) and an eight steps increase in cadence (95% CI, 4.9-11.3) observed after the heel lift.
Conclusions:
This pilot study has demonstrated that addition of 1 cm heel may be effective in improving the walking performance of persons with Cauda Equina Syndrome. Future studies should investigate the kinetic and kinematic changes of this modification using a randomized controlled trial study design.
