Biomechanics of uphill walking using custom ankle-foot orthoses of three different stiffnesses

Haight, Derek J.; Esposito, Elizabeth Russell; Wilken, Jason M.

doi:10.1016/j.gaitpost.2015.01.001

Cited by 22 publications

(18 citation statements)

References 29 publications

(33 reference statements)

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“…Inconsistent preferences in PD-AFO design between limb salvage subjects has also been observed when investigating PD-AFO stiffness in both level (Russell Esposito et al, 2014) and sloped walking (Haight et al, 2015). In addition, Raschke et al (2015) suggested that there may be a link between prosthetic foot design preference and gait biomechanics, with individuals tending to prefer a prosthetic foot stiffness that minimized peak sagittal plane joint moments.…”

Section: Discussionmentioning

confidence: 89%

“…Passive-dynamic ankle-foot orthoses (PD-AFOs) are commonly prescribed to augment impaired ankle muscle function and restore walking ability in individuals with various lower-limb mobility impairments by providing elastic energy storage and return. Previous studies have demonstrated the beneficial effects of PD-AFOs on individuals with gait limitations (Desloovere et al, 2006;Patzkowski et al, 2012;Van Gestel et al, 2008), and have specifically examined the influence of PD-AFO stiffness on gait performance (Arch and Stanhope, 2015;Haight et al, 2015;Harper et al, 2014a;Russell Esposito et al, 2014) and energy cost (Bregman et al, 2011). However, the design and prescription process remains largely qualitative and modifications to PD-AFO design characteristics other than stiffness may be advantageous.…”

Section: Introductionmentioning

confidence: 99%

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The influence of passive-dynamic ankle-foot orthosis bending axis location on gait performance in individuals with lower-limb impairments

Ranz

Esposito

Wilken

et al. 2016

Clinical Biomechanics

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

The influence of passive-dynamic ankle-foot orthosis bending axis location on gait performance in individuals with lower-limb impairments

Ranz

Esposito

Wilken

et al. 2016

Clinical Biomechanics

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“…For instance, the energy-storing, spring-like carbon-composite Ankle Foot Orthoses (Bregman et al, 2012); (Radtka et al, 2005); (Ploeger et al, 2015); (Alvela et al, 2015); (Meyns et al, 2016); (Kato et al, 2012); (Neviani, Borghi, Costi, & Ferrari, 2012) devote to reduce the energy cost of walking, and the active ankle foot orthosis (AAFO) (Hamid et al, 2012); (Ploeger et al, 2012); is prone to control critical ankle motion during dorsiflexion and plantarflexion automatically through using the flexiforce sensor, rather than adjusts it manually. On account that each patient has his own gait pattern and symptom, the effect of AFO seems to vary between patients (Westberry et al, 2007); (Haight, Russell Esposito, & Wilken, 2015); (Hyun, Kim, Han, & Kim, 2015); (van Beeten, Hartman, & Houdijk, 2015); (Ries & Schwartz, 2015); (Sabbagh, Fior, & Gentz, 2014). Therefore, it is crucial for a clinician to select an optimal AFO for patients after fully understanding the causes and symptoms of patients.…”

Section: Discussionmentioning

confidence: 99%

The Categories of AFO and Its Effect on Patients With Foot Impair: A Systemic Review

Feng

Song

2017

Physical Activity and Health

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There are a lot of ailments that would lead to foot impair. For instance, cerebral palsy (CP), stroke, multiple sclerosis (MS), hemiplegia, duchenne muscular dystrophy (DMD) and so on. With the further deterioration of these diseases, gait would become imbalanced and then it may contribute to high risk of fall incidence. Thus, it is urgent to invent a tool to adjust the foot impair. Most of the previous studies had found that the ankle-foot orthoses (AFO) has a significant effect to overcome the foot impair. Studies that investigated the ankle-foot orthoses (AFO) and its effect on patients with foot impair are various and abundant. Nevertheless, there are a little studies that integrated the categories of AFO and its specific effect on patients with foot impair. It is important to integrate the categories of AFO and its specific effect on patients with foot impair because the previous studies had proved that different designs of AFO have different mechanical properties and these would affect outcomes in a way. The purpose of this paper is to review and integrate the published studies on the categories of AFO and its effect on patients with foot impair and thereby offer better guidelines and suggestions for prescriptions and future studies. The publication of all papers about the categories of AFO and its effect on patients with foot impair were obtained from Science Direct(SD), Google Scholar and other peer reviewed journals that were published in English. The keywords used for searching were "AFO," "material," "foot impair," and "systemic review." There were total 8647 studies regarding these keywords, and 37 studies were eligible to be selected in this research: 2 studies on systemic review, 35 studies on the materials and categories of AFO and its effect on patients with foot impair. Most previous studies had found that the effect of AFO is related to mechanical properties of AFO and disease characteristics. Therefore, this review could provide researchers with more systemic and detailed information about the categories of AFO and its effect on patients with foot impair and promote synthesis of literature.

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“…However, because of the passive spring like nature of traditional AFOs, they only return to a neutral position when unloaded, rather than producing the peak power and work observed in the intact ankle. As a result, gait quality and performance may still be limited [ 9 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Experimental comparisons of passive and powered ankle-foot orthoses in individuals with limb reconstruction

Esposito

Schmidtbauer

Wilken

2018

J NeuroEngineering Rehabil

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BackgroundAnkle-foot orthoses (AFO) are commonly prescribed to provide functional assistance for patients with lower limb injuries or weakness. Their passive mechanical elements can provide some energy return to improve walking ability, but cannot restore plantar flexor push-off. Powered AFOs provide an assistive torque about the ankle to address the limitations of passive devices, but current designs have yet to be implemented on a large scale clinically. Purpose: To compare passive AFOs to a new untethered, powered AFO design in a clinical population with lower limb reconstruction.MethodsA crossover study design, conducted on three individuals with lower limb reconstruction, compared gait mechanics at a standardized speed (based on leg length) in 4 AFO conditions: 1. None (shoes only), 2. Blue Rocker (BR, Allard, USA), 3. Intrepid Dynamic Exoskeletal Orthosis (IDEO), and 4. PowerFoot Orthosis (PFO BionX Medical Technologies, Inc.). The PFO was a custom, battery-powered device whose damping and power were capable to being tuned to meet patient needs. Subjects performed biomechanical gait analysis and metabolic testing at slow, moderate and fast speeds. Dependent variables included total limb power (calculated using a unified deformable segment model), mechanical work, mechanical efficiency, ankle motion, net metabolic cost across three speeds, and performance measures were calculated. Effect sizes (d) were calculated and d > 0.80 denoted a large effect.ResultsNet positive work (d > 1.17) and efficiency (d > 1.43) were greatest in the PFO. There were large effects for between limb differences in positive work for all conditions except the PFO (d = 0.75). The PFO normalized efficiency between the affected and unaffected limbs (d = 0.50), whereas efficiency was less on the affected limb for all other conditions (d > 1.69). Metabolic rate was not consistently lowest in any one AFO condition across speeds. Despite some positive results of the PFO, patient preferred their daily use AFO (2 IDEO, 1 BR). All participants indicated that mass and size were concerns with using the PFO.ConclusionsA novel PFO resulted in more biomimetic mechanical work and efficiency than commercially-available and custom passive AFO models. Although the powered AFO provided some biomechanical benefits, further improvements are warranted to improve patient satisfaction.

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Biomechanics of uphill walking using custom ankle-foot orthoses of three different stiffnesses

Cited by 22 publications

References 29 publications

The influence of passive-dynamic ankle-foot orthosis bending axis location on gait performance in individuals with lower-limb impairments

The influence of passive-dynamic ankle-foot orthosis bending axis location on gait performance in individuals with lower-limb impairments

The Categories of AFO and Its Effect on Patients With Foot Impair: A Systemic Review

Experimental comparisons of passive and powered ankle-foot orthoses in individuals with limb reconstruction

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