Influence of Rehabilitation Aid Use on Obstacle Height During Gait in Patients with Foot Drop: A Case Series Study

The study explored differences in gait characteristics and biomechanics according to rehabilitation aid use (normal gait (NG) vs. assisted gait (AG) groups) and obstacle height (0, 5, and 15 cm conditions) in patients with stroke-induced foot drop.

A longitudinal study, within-subjects, repeated-measures study was conducted in 10 patients with mild foot drop. Participants walked at their preferred speed on a 10-m indoor track while crossing obstacles of three heights (0, 5, and 15 cm) under two gait conditions (normal walking (NG) and assisted walking (AG). The order of gait conditions and obstacle heights was randomized clinical within participants. Synchronized 3D motion capture with force plate measurements was used to calculate spatiotemporal variables, including ground reaction force (GRF), lower extremity joint angles at heel contact (HC), and toe-off (TO). A two-way repeated-measures ANOVA was used to examine the main effects and interaction effects of gait condition (NG vs. AG) and obstacle height (0, 5, and 15 cm).

AG showed little change in gait pattern, while there was a significant interaction between height and group. The vertical GRF (Fz) was lower in AG than NG at 5 cm, indicating reduced initial impact. There was a significant interaction for right medial-lateral (ML) GRF, with AG showing a small ML directional GRF over low obstacles (0-5 cm). At HC, AG was associated with an increase in right ankle dorsiflexion and right knee flexion. AG led to a reduction in left hip angle in the sagittal plane, and a smaller right ankle angle in the frontal plane, suppressing ML sway. At TO, AG caused an increase in right knee flexion, and bilateral ankle angles in the frontal plane at 5 cm.

Rehabilitation aids reduced impact at initial contact, enhanced frontal plane stability, improved knee flexion and ankle alignment during the propulsion transition phase, and contributed to reduced variability and improved gait stability. The findings suggest potential utility for public health implications ambulation over curbs and thresholds, warranting larger, adequately powered clinical outcome trials.