The effects of high custom made shoes on gait characteristics and patient satisfaction in hemiplegic gait

Objective: To determine the effects of a temporary high custom made orthopaedic shoe on functional mobility, walking speed, and gait characteristics in hemiplegic stroke patients. In addition, interference of attentional demands and patient satisfaction were studied. Design: Clinical experimental study. Setting: University Medical Centre. Participants: Nineteen stroke patients (12 males; mean age 55 years (standard deviation (SD) 10 years); mean time post onset 3.6 months (SD 1.4 months)) with a spastic paresis of the lower extremity. Main outcome measures: Functional mobility was assessed with the timed up and go test, walking speed and gait characteristics were measured with clinical gait analysis and performed with and without a verbal dual task. Patient satisfaction was determined with a questionnaire. Results: Walking with the high orthopaedic shoe resulted in improved functional mobility (22%; p <.001), walking speed (37%; p <.001) and gait characteristics compared to walking with normal shoes. The dual task interfered with functional mobility during walking. The interference was equally big for normal shoes as for the orthopaedic shoe. Patients evaluated walking with the high orthopaedic shoe as an improvement (p <.001). An average of 84% reported improvements in foot lifting, swing progression, taking weight, confidence while walking, safety, walking distance and walking speed. Conclusion: In the early recovery phase after stroke, when regaining walking ability, a temporary high orthopaedic shoe can improve hemiplegic gait, even with dual task interference. (C) 2011 Elsevier B.V. All rights reserved.