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Effects of plastic and metal leg braces on speed and energy cost of hemiparetic ambulation
Corcoran PJ, Jebsen RH, Brengelmann GL, Simons BC
Archives of Physical Medicine and Rehabilitation 1970 Feb;51(2):69-77
clinical trial
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Plastic short leg braces have been used in recent years because of their obvious cosmetic advantage over conventional metal bracing. To determine whether they also offer a mechanical advantage, comparisons were made using oxygen consumption at controlled walking speeds in 15 hemiparetic patients. The trend observed toward lower energy costs with a plastic brace to be neither statistically nor clinically significant. However, walking with either type of brace significantly lowered oxygen consumption observed in the same patient when walking without a brace. The patients appeared to utilize the biomechanical advantage of the brace to achieve increased walking speeds. Unlike some previous investigators, the authors consistently found that ambulation in hemiparetic patients required higher energy expenditures from 51 to 67% than in normal subjects at the same slow speeds. Accurate control of speed is essential in any studies of the effects of physical agents on ambulation.

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