Effects of high orthopedic shoes on walking ability in stroke patients.

One of the major goals during rehabilitation of stroke patients is regaining
the ability to walk. Gait abnormality after stroke is due to a variety of
disorders, depending on the localization and severity of the lesion. In stroke
patients motor tasks are not performed automatically and cognitive control is
needed during walking. Studies show that performing a verbal task during
walking in patients with brain damage has a negative effect on walking ability.
By compensating paresis and coordination disorders and by correcting joint
immobility and instability, walking ability may be advanced. For this purpose a
variety in leg orthoses can be prescribed.
Insight into the effect of orthoses on the walking ability and gait of stroke
patients is important while making a decision on what sort of orthosis to
prescribe. Ankel foot orthoses can have a positive effect on walking ability
and gait characteristics of stroke patients. Research on the effect of high
orthopedic shoes on walking ability in stroke patients is virtually lacking.

The aim of this study is to determine the effect of high orthopedic shoes on
walking ability in stroke patients and to evaluate the effect of a period of
exercising with high orthopedic shoes.
Primary question:
To evaluate quantitative and qualitative effect of high orthopedic shoes on
walking ability in stroke patients as well as on dual task interference.
Secondary questions:
To evaluate the effect of a period of exercising with high orthopedic shoes on
quantitative and qualitative parameters as well as on dual task interference.

The design is longitudinal prospective study.

The measurements are performed twice: no longer than two weeks after the
patient has worn the high orthopedic shoes for the first time (T1) and after
the patient has worn the high orthopedic shoes for a period of 2 months, plus
or minus 2 weeks (T2).
The measurments include a short clinical examination (to evaluate spasticity,
mobility and voluntary movements), a Timed up and go test and 2 Minute walking
test in which the patient is asked to rise from a chair and walk short
distances and a video registration of the patient walking a short distance
(gait analysis). At the end the patient is given a questionnaire of 13 multiple
choice questions.
The clinical examination, Timed up and go test, 2 Minute walking test and gait
analysis are widely used by rehabilitation specialists and fysical therapists
during the rehabilitation period. These tests are associated with minimal
fysical burden and risks for patients.
One measurement takes approximately 3 hours, in between the tests the patient
is able to rest on a chair. During the walking tests a person is walking beside
the patient to ensure safety.
With this study we can obtain useful scientific data, which give important
clinical information. Participation is associated with minimal risk and fysical
burden. Therefor, in my opinion, this study is justified.