Date of Award

2008

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Meridee Danks

Keywords

Gait Disorders, Neurologic; Paresis -- rehabilitaiton; Shoes

Abstract

People with hemiparesis can have difficulty weight-bearing through their involved lower extremity. This can lead to asymmetry during static standing and dynamic activities including gait. Previous research has shown improved symmetry in static standing when a heel lift is inserted under the non-paretic lower extremity. The purpose of this study is to determine if a heel lift can improve symmetry during dynamic gait in people with hemiparesis.

Five subjects (1 female, 4 male) with unilateral hemiparesis were recruited from the community. All demonstrated greater than 55% of weight-bearing on the non-paretic limb in static standing. Hemiparesis resulted from either a stroke or a brain tumor. Gait parameters were measured using the GAITRite® walkway system. Subjects ambulated a minimum of 20 steps both with and without a 9.5 mm heel lift inserted. Gait velocity, step length, single limb support time, and swing time were analyzed for each test condition.

Subjects could not be compared due to the variation between them. A series of five case studies are presented based on individual findings as measured by percent change. A heel lift under the non-paretic limb showed greater weight shifting onto the paretic limb for one subject. Improved gait velocity and symmetry in step length were noted for this subject. Another subject subjectively reported that the heel lift insert made ambulation easier for him, even though analysis of the gait parameters showed little change in his gait symmetry. Use of the heel lift successfully improved gait symmetry in one subject and was subjectively beneficial to another subject. No definite conclusion can be made overall, but it does appear that use of a 9.5 mm heel lift may improve weight -bearing onto the paretic lower extremity and subsequently lead to greater symmetry during dynamic gait activities in certain subjects with hemiparesis.

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