Dynamic assist by carbon fiber spring AFOs for patients with myelomeningocele

Wolf, Sebastian I.; Alimusaj, Merkur; Rettig, Oliver; Döderlein, Leonhard

doi:10.1016/j.gaitpost.2007.11.012

Cited by 77 publications

(48 citation statements)

References 7 publications

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“…These results are also in agreement with footwear literature that reports less knee flexion in soft midsole (ie, more compliant) running shoes [28]. In theory, an AFO with spring-like material properties that stores energy during midstance and returns the maximum amount of energy during late stance/preswing should be most beneficial to the user [3,12,42]. However, Bregman et al [6] undertook a simulation approach to investigate how different stiffnesses affected walking biomechanics and found that the optimal (least metabolic cost) stiffness occurred when hip compensations were minimized.…”

Section: Discussionsupporting

confidence: 89%

“…The resulting gait is mechanically inefficient [8,22] and leads to elevated energy cost [29,39]. Most passive-dynamic AFOs help compensate by functioning as a spring that stores energy when initially deformed in midstance and returns energy at the end of stance [2,12,42]. The stiffness of a dynamic AFO can be optimized to alleviate gait-related problems [4,18,36] because it determines the extent to which the AFO maintains the ankle in a neutral position, provides mediolateral stability, and aids propulsion through energy storage and return mechanisms [25,36].…”

Section: Introductionmentioning

confidence: 99%

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How Does Ankle-foot Orthosis Stiffness Affect Gait in Patients With Lower Limb Salvage?

Esposito

Blanck

Harper

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Ankle-foot orthoses (AFOs) are commonly prescribed during rehabilitation after limb salvage. AFO stiffness is selected to help mitigate gait deficiencies. A new custom dynamic AFO, the Intrepid Dynamic Exoskeletal Orthosis (IDEO), is available to injured service members but prescription guidelines are limited. Questions/purposes In this study we ask (1) does dynamic AFO stiffness affect gait parameters such as joint angles, moments, and powers; and (2) can a given dynamic AFO stiffness normalize gait mechanics to noninjured control subjects? Methods Thirteen patients with lower limb salvage (ankle arthrodesis, neuropathy, foot/ankle reconstruction, etc) after major lower extremity trauma and 13 control subjects who had no lower extremity trauma and wore no orthosis underwent gait analysis at a standardized speed. Patients wore their custom IDEO with posterior struts of three different stiffnesses: nominal (clinically prescribed stiffness), compliant (20% less stiff), and stiff (20% stiffer). Joint angles, moments, powers, and ground reaction forces were compared across the varying stiffnesses of the orthoses tested and between the patient and control groups. Results An increase in AFO compliance resulted in 20% to 26% less knee flexion relative to the nominal (p = 0.003) and stiff (p = 0.001) conditions, respectively. Ankle range of motion and power generation were, on average, 56% (p \ 0.001) and 63% (p \ 0.001), respectively, less than controls as a result of the relatively fixed ankle position. Conclusions Patients with limb salvage readily adapted to different dynamic AFO stiffnesses and demonstrated few Support was provided by

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

How Does Ankle-foot Orthosis Stiffness Affect Gait in Patients With Lower Limb Salvage?

Esposito

Blanck

Harper

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…[1][2][3] Various designs are available ranging from flexible to rigid ones and a wide range of materials (e.g. thermoplastic, carbon fiber, leather and metal) are used to fabricate AFOs.…”

Section: Introductionmentioning

confidence: 99%

Effects of joint alignment and type on mechanical properties of thermoplastic articulated ankle-foot orthosis

Gao

Carlton

Kapp

2011

Prosthetics &Amp; Orthotics International

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Background: Articulated or hinged ankle-foot orthosis (AFO) allow more range of motion. However, quantitative investigation on articulated AFO is still sparse. Objective: The objective of the study was to quantitatively investigate effects of alignment and joint types on mechanical properties of the thermoplastic articulated AFO. Study design: Tamarack dorsiflexion assist flexure joints with three durometers (75, 85 and 95) and free motion joint were tested. The AFO joint was aligned with the center of the motor shaft (surrogate ankle joint), 10 mm superior, inferior, anterior and posterior with respect to the motor shaft center. Methods: The AFO was passively moved from 20 plantar flexion to 15 dorsiflexion at a speed of 10 /s using a motorized device. Mechanical properties including index of hysteresis, passive resistance torque and quasi-static stiffness (at neutral, 5, 10 and 15 in plantar flexion) were quantified. Results: Significant effects of joint types and joint alignment on the mechanical properties of an articulated thermoplastic AFO were revealed. Specifically, center alignment showed minimum resistance and stiffness while anterior and posterior alignment showed significantly higher resistance and stiffness. The dorsiflexion assist torques at neutral position ranged from 0.69 AE 0.09 to 1.88 AE 0.10 Nm. Conclusions: Anterior and posterior alignment should be avoided as much as possible. Clinical relevanceThe current study suggested that anterior and posterior alignment be avoided as much as possible in clinical practice due to potential skin irritation and increase in stress around the ankle joint.

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“…Also TCF AFO is energy storage device that may be well suited to assist in the push-off phase of walking as well as preventing foot drop during the swing phase. [4] [5].Hence by FEM method they get the best result from CF-AFO than thermoplastics that is polypropylene in the energy return point also and maximum load carrying capacity also. [4][5][6] Also for stress distribution in ankle foot orthosis a quasi-static 3-D finite element analysis of AFO is carried out and from this analysis they find out the maximum peak stress in the region of heel, neck, and side-arc region of AFO.…”

Section: Finite Element Methodsmentioning

confidence: 98%

“…1993), is caused by a weakness in the dorsiflexor muscles that lift the foot. This is caused by stroke, cerebral palsy (CP) [3], myelomeningocele [5], multiple sclerosis (MS) (Taylor et al, 1999), and neurological trauma, such as accidents or surgical complications. To find solution on this they apply ankle biomechanics, engineering principles and current robotic technology to develop an improved, adaptive and autonomous system to assist drop foot gait.Motivation-The major motivation behind this researcher effort is to assist those individuals with gait disabilities.…”

Section: Introductionmentioning

confidence: 99%

Review: Analysis and Manufacturing of Ankle Foot Orthosis for Foot Drop

Pawale¹

2017

IOSR JMCE

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Dynamic assist by carbon fiber spring AFOs for patients with myelomeningocele

Cited by 77 publications

References 7 publications

How Does Ankle-foot Orthosis Stiffness Affect Gait in Patients With Lower Limb Salvage?

How Does Ankle-foot Orthosis Stiffness Affect Gait in Patients With Lower Limb Salvage?

Effects of joint alignment and type on mechanical properties of thermoplastic articulated ankle-foot orthosis

Review: Analysis and Manufacturing of Ankle Foot Orthosis for Foot Drop

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