足関節内反尖足矯正 strap の試用 : Rie strap の紹介及び評価

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Purpose: In recent years, the AFO, which is more suitable for the symptom, has been developed and is constructed of new plastics materials. However, consideration for patients midway between the AFO group and the non-AFO group is insufficient. We, there fore, developed a type of strap made of one piece of leather as an apparatus for replacing the conventional foot suspender, whereby the sole and the posterior of the distal crus are crossed in a 8-figure at the anterior of the ankle joint and the lateral side of the foot is pulled and fixed with the 'vercro'. Thus, both plantar flexion and inversion can be restricted, with good results. We, therefore, designated the new strap as the Rie (reformation of inversion and equinus) Strap and here would like to introduce it and evaluate its effect, together with its indication and some discussion. Method: The following points were examined in 13 subjects, including healthy persons and patients with CVA, peripheal nerve injury, and muscular diseases, using a force plate, foot switch, and foot print, before and after adaptation of the Rie Strap: 1) The component force of ground reaction 2) Stride duration 3) Patterns of contacting and decontacting the floor 4) Sole pressure distribution Results: The following points were noted after adapting the Rie Strap: 1) A decrease in decelerating power and accelerating power of ground reaction was obseraved. 2) Stride duration showed a decrease but walking speed increased. 3) Improvements from the toe-heel gait or strap gait to the stamp gait or heel-toe gait, respectively, were observed. 4) The sole pressure distribution, which had been concentrated on the antero-lateral region of the sole, was dispersed toward the postero-medial regions. Discussion: It was considered from these results that the Rie Strap had a reformative capacity both for plantar flexion and inversion, and that its indications should be as follows, with the principle of the passive ankle-dorsi-flexion range of motion (with knee extension's position) to be above 0°: 1) Inversion and equinus deformity due to spastic palsy become low a medium degree. 2) Dropped foot due to weakness of the ankle-dorsi-flexors Because of little elasticity of the Rie Strap, in cases of dropped foot, foot flat or push off is hard to obtain, and its indication may be lower than inversion and equinus deformity in cases of CVA. The new device is not without some defects, such as difficulty in wearing it with one hand and manufacturing it, but these problems are gradually being improved with modified types.
1983-04-25

足関節内反尖足矯正 strap の試用 : Rie strap の紹介及び評価

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