Effects of an ankle-foot orthosis on spatiotemporal parameters and energy cost of hemiparetic gait

Franceschini, Marco; Massucci, Maurizio; Ferrari, Lilia; Agosti, Maurizio; Paroli, Chiara

doi:10.1191/0269215503cr622oa

Cited by 115 publications

(92 citation statements)

References 13 publications

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“…[1][2][3][4][5][6][7][8][9] Impairments in ambulation post stroke stem from diminished dorsiflexion of the ankle with resulting sustained plantarflexion and inversion of the ankle during the swing phase of gait, a lack of eccentric control of ankle dorsiflexion during weight acceptance and a decrease in gait velocity. 1,[10][11][12] Multiple studies have demonstrated improved ankle kinematics, improved symmetry, and increased velocity when individuals post stroke walk with an orthosis.…”

Section: Introductionmentioning

confidence: 99%

“…1,[10][11][12] Multiple studies have demonstrated improved ankle kinematics, improved symmetry, and increased velocity when individuals post stroke walk with an orthosis. [1][2][3][4][5][6][7][8][9] Secondary to the increased understanding of plasticity of the brain, healthcare providers are hesitant to use an AFO for individuals post stroke because they fear using an orthosis encourages disuse of the tibialis anterior (TA) muscle and decreases opportunity for motor relearning with the end result of permanent gait impairments, and a dependence upon bracing. 7,13 Hesse et al 7 investigated electromyography (EMG) of the TA muscle and recorded a decrease in activation when individuals post stroke walked with a rigid AFO compared to walking without an AFO.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of tibialis anterior muscle electromyography, ankle angle, and velocity when individuals post stroke walk with different orthoses

Lairamore

Garrison

Bandy

et al. 2011

Prosthetics &Amp; Orthotics International

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Background: Ankle-foot orthoses (AFO) have been used to improve the gait of individuals post stroke, but their use has come into question secondary to increased understanding of motor re-learning. Objectives: The purpose of this study was to determine if there is a change in tibialis anterior muscle electromyography, ankle angle, or gait velocity when individuals post stroke walk with a posterior leaf-spring AFO (PLAFO) or a dynamic ankle orthosis (DAO). Study Design: Repeated measures. Methods: Fifteen participants post stroke walked without an orthosis, with a PLAFO, and with a DAO. Data were gathered using electromyography, force plates, and three-dimensional motion analysis cameras. A repeated measures ANOVA was used to test for statistical significance (p 0.05). Results: Participants exhibited significantly less tibialis anterior muscle electromyography during the swing phase of gait with use of a DAO (p < 0.001). No change in velocity or ankle angle was exhibited with use of either orthosis. Conclusions:The results support therapists' notions that bracing can lead to a decline in tibialis anterior muscle activity during the swing phase of gait. The results also showed no improvement in gait velocity when either orthosis was used by participants who could walk without an orthosis. Clinical relevanceFirst, the use of relatively flexible orthoses can cause a decline in tibialis anterior muscle activity during the swing phase of gait. Secondly, neither the posterior leaf-spring ankle-foot orthosis nor the dynamic ankle orthosis should be prescribed to improve gait velocity in individuals who are able to walk without bracing.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of tibialis anterior muscle electromyography, ankle angle, and velocity when individuals post stroke walk with different orthoses

Lairamore

Garrison

Bandy

et al. 2011

Prosthetics &Amp; Orthotics International

View full text Add to dashboard Cite

show abstract

“…20 Previous research has focused primarily on the duration of double support but has failed to further evaluate the specific characteristics of weight transfer during this phase of gait. [30][31][32] As a result, this research focuses on the double support portion of the gait cycle to evaluate transfer of momentum during limb loading using a novel weight transfer analysis.…”

Section: Introductionmentioning

confidence: 99%

Weight transfer analysis in adults with hemiplegia using ankle foot orthosis

Nolan

Yarossi²

2011

Prosthetics &Amp; Orthotics International

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Background: Identifying and understanding the changes in transfer of momentum that are directly affected by orthotic intervention are significant factors related to the improvement of mobility in individuals with hemiplegia. Objectives: The purpose of this investigation was to use a novel analysis technique to objectively measure weight transfer during double support (DS) in healthy individuals and individuals with hemiplegia secondary to stroke with and without an ankle foot orthosis. Study design: Prospective, Repeated measures, case-controlled trial. Methods: Participants included 25 adults with stroke-related hemiplegia >6 months using a prescribed ankle foot orthosis and 12 age-matched healthy controls. Main outcome measures included the weight transfer point timing (WTP, %DS), maximum total force timing (MTF, %DS), timing difference between WTP and MTF (MTF-WTP, %DS) and the linearity of loading (LOL, R 2 ) during the DS phase of the gait cycle. Results: The WTP and LOL were significantly different between conditions with and without the ankle foot orthosis for the affected and unaffected limb in post-stroke individuals, p 0.01. The MTF and difference in timing between MTF-WTP were significantly different during affected limb loading with and without the ankle foot orthosis in the stroke group, p 0.0001 and p ¼ 0.03, respectively. MTF, MTF-WTP and LOL were significantly different between individuals with stroke (during affected limb loading) and healthy controls (during right limb loading). Conclusions: This research established a systematic method for analysing weight transfer during walking to evaluate the effect of an ankle foot orthosis on loading during double support in hemiplegic gait. This novel method can be used to elucidate biomechanical mechanisms behind orthosis-mediated changes in gait patterns and quantify functional mobility outcomes in rehabilitation. Clinical relevanceThis novel approach to orthotic assessment will provide the clinician with needed objective evidence to select the most effective orthotic intervention to maximize functional recovery for individuals with hemiplegia secondary to stroke.

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“…Foot drop is defined as a weakness or failure of function in the tibialis anterior, causing restricted functional movement, a slowing down of walking speed and an increased risk of falling [1,2]. Several reasons for foot drop have been reported in literature.…”

Section: Introductionmentioning

confidence: 99%

New and unusual causes of foot drop

Aldemir¹,

Duygun²

2017

Med-Science

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Several reasons for foot drop have been reported in literature. In recent years, innovations have been added associated with some current treatment methods. The study comprised 12 patients who presented with foot drop, with rarely seen or not previously encountered causes. The patients comprised 6 males and 6 females with a mean age of 41.25 years (range, 18-72 years). The etiology of the foot drop which developed in the patients was after taking the peroneus longus tendon as autograft with a tendon stripper in 2 cases, after revision total knee arthroplasty in 1 case, after primary total knee arthroplasty in 2 cases, after a fall while playing football in 1, after injection in 3, secondary to bilateral compartment syndrrome in 1, after lying in a lateral position for a long time during a kidney operation in 1 and following a burn injury in 1 case. Of the total 12 patients, transfer of the tibialis posterior tendon to the anterior was applied in 4 cases. Decompression and fasciotomy was applied to 2 cases. In 3 cases, surgical tendon transfer was recommended but the patients rejected this treatment. Conservative follow-up was applied to 3 cases. The 4 patients applied with tendon transfer returned to daily activities problem-free. In the 2 cases applied with decompression and fasciotomy, full sensory and motor functions returned to normal in the 15th and 16th week. The motor and sensory functions of the 3 patients followed up conservatively returned to normal in the 14th-15th weeks. Foot drop is the result of an underlying problem rather than a disease per se. New treatment methods applied in orthopaedic surgery may cause the development of unusual foot drop. An awareness of these is necessary together with a detailed anamnesis, examination and laboratory tests to be able to determine the reason and plan treatment.

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Effects of an ankle-foot orthosis on spatiotemporal parameters and energy cost of hemiparetic gait

Cited by 115 publications

References 13 publications

Comparison of tibialis anterior muscle electromyography, ankle angle, and velocity when individuals post stroke walk with different orthoses

Comparison of tibialis anterior muscle electromyography, ankle angle, and velocity when individuals post stroke walk with different orthoses

Weight transfer analysis in adults with hemiplegia using ankle foot orthosis

New and unusual causes of foot drop

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