Effect of ankle-foot orthosis on active ankle moment in patients with hemiparesis

Miyazaki, Satoru; Yamamoto, Sumiko; Kubota, Toshio

doi:10.1007/bf02534094

Cited by 39 publications

(23 citation statements)

References 4 publications

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“…This increase in knee flexion motion and moments with restriction of plantar flexion mobility in loading is also consistent with prior studies, with the magnitude of increased demand at the knee corresponding to the extent of plantar flexion rigidity. [10][11][12][13]24,25 Contrary to our hypothesis, an increase in EMG intensity of the vastus intermedius muscle was not seen with either the Rigid or PS AFO. This may have been due to excessive knee flexion occurring in all four conditions during initial contact and loading with moderate to high EMG intensity of the vastus intermedius muscle.…”

Section: Discussionmentioning

confidence: 65%

Effect of AFO Design on Walking after Stroke

Mulroy¹,

Eberly²,

Gronely³

et al. 2010

Prosthetics &Amp; Orthotics International

113

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This study was conducted to compare the effects of three ankle-foot orthosis (AFO) designs on walking after stroke and determine whether an ankle plantar flexion contracture impacts response to the AFOs. A total of 30 individuals, ranging from 6-215 months post-stroke, were tested in four conditions: shoes only (SH), dorsi-assist/dorsi-stop AFO (DA-DS), plantar stop/free dorsiflexion AFO (PS), and rigid AFO (Rigid). Kinematics, kinetics, and electromyographic (EMG) activity were recorded from the hemiparetic lower extremity while participants walked at a self-selected pace. Gait parameters were compared between conditions and between participants with and without a moderate ankle plantar flexion contracture. All AFOs increased ankle dorsiflexion in swing and early stance. Anterior tibialis EMG was reduced only in the PS AFO. Both PS and Rigid AFOs restricted ankle plantar flexion and increased knee flexion in loading. Peak ankle dorsiflexion in stance and soleus EMG intensity were greatest in the PS AFO. The Rigid AFO tended to restrict dorsiflexion in stance and knee flexion in swing only in participants without a plantar flexion contracture. Individuals without a contracture benefit from an AFO that permits dorsiflexion mobility in stance and those with quadriceps weakness may more easily tolerate an AFO with plantar flexion mobility in loading.

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Section: Discussionmentioning

confidence: 65%

Effect of AFO Design on Walking after Stroke

Mulroy¹,

Eberly²,

Gronely³

et al. 2010

Prosthetics &Amp; Orthotics International

113

View full text Add to dashboard Cite

show abstract

“…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%

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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“…Functional analysis involved the use of gait analysis and strategies that provide AFO performance indicators using strain gauges [6,[31][32][33][34] or an experimental AFO [7][8][35][36][37].…”

Section: Methods Of Testing Ankle-foot Orthosis Rigiditymentioning

confidence: 99%

“…A series of functional studies have been conducted with experimental AFOs whose ankle joint resistance to plantar flexion and dorsiflexion directions could be adjusted in an attempt to quantify an optimal AFO rigidity for patients with a gait-limiting pathology [7][8][35][36]. These studies developed techniques to quantify the moment generated by an AFO separately from the moment generated by the floor reaction force and muscles during gait.…”

Section: Studies Using Experimental Ankle-foot Orthosesmentioning

confidence: 99%

Techniques to measure rigidity of ankle-foot orthosis: A review

Kobayashi

Leung

Hutchins

2011

JRRD

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Abstract-We performed this review to provide a clearer understanding of how to effectively measure ankle-foot orthosis (AFO) rigidity. This information is important to ensure appropriate orthotic intervention in the treatment of patients with pathological gait. The two main approaches to the investigation of AFO rigidity are (1) bench-testing analyses, in which an AFO is fixed or attached to a measurement device, and (2) functional analyses, in which measurements are taken while a subject is walking with an AFO in situ. This review summarizes and classifies the current state of knowledge of AFO rigidity testing methods. We analyzed the strengths and weaknesses of the methods in order to recommend the most reliable techniques to measure AFO rigidity. The information obtained from this review article would, therefore, benefit both clinicians and engineers involved in the application and design of AFOs.

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Effect of ankle-foot orthosis on active ankle moment in patients with hemiparesis

Cited by 39 publications

References 4 publications

Effect of AFO Design on Walking after Stroke

Effect of AFO Design on Walking after Stroke

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

Techniques to measure rigidity of ankle-foot orthosis: A review

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