The effect of a powered ankle foot orthosis on walking in a stroke subject: a case study

Pourghasem, Ali; Takamjani, Ismail Ebrahimi; Karimi, Mohammad Taghi; Kamali, Mohammad; Jannesari, Mohammad; Salafian, Iman

doi:10.1589/jpts.28.3236

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…Two studies [35,37] explored a more compliant orthotic system by employing a dynamic AFO. From the fulltext article analysis, it was verified that the selected studies with active orthotic devices [7,8,[39][40][41][42][43] did not accomplish randomized trials. As these studies did not meet the seventh eligibility criterium, they were not included in the systematic analysis.…”

Section: Methodologic Quality Assessmentmentioning

confidence: 99%

Outcome measures and motion capture systems for assessing lower limb orthosis-based interventions after stroke: a systematic review

Figueiredo

Moreno

Matias

et al. 2019

Disability and Rehabilitation: Assistive Technology

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To review and categorize, according to the International Classification of Functioning, the outcome measures, and motion capture systems for studying the evidence-based practice of orthotic-based interventions in post-stroke gait rehabilitation. Methods: An electronic literature search was conducted up to February 2018 in Web of Science, Scopus, MEDLINE, and Physiotherapy Evidence Database. Randomized trials measuring activity, impairment, or participation outcome measures for studying the evidence-based practice of orthoses in gait rehabilitation after an acute or chronic stroke were identified. The studies were assessed through the Cochrane risk-of-bias tool by three authors. Information about stroke's stage, assessment protocol (goal, timing, and motion capture system), orthosis configuration, and outcome measures were extracted. Results: Eighteen randomized trials, including 387 post-stroke adults, mostly in the chronic stage, were selected. They assessed 39 outcomes, mainly activity outcome measures such as spatiotemporal (72.2%), kinematic (44.4%), and functional (33.3%) outcomes. Gait speed was the primary outcome in most studies. Participation (22.2%) and impairment (16.7%) outcome measures were less explored. Mostly, non-portable motion capture systems were employed opposing the freely-use of the wearable orthosis. The detection bias risk and the shortage of baseline and follow-up outcome measures affected the studies' assessment quality.Conclusionsː Studies showed heterogeneity in selecting outcomes and timings for assessment. There is evidence for assessing the evidence of orthosis-based gait rehabilitation after stroke through activity outcome measures, primarily the gait speed, recorded by non-wearable motion capture systems. A unified methodology considering wearable sensors for tracking baseline and follow-up measures is needed.

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Section: Methodologic Quality Assessmentmentioning

confidence: 99%

Outcome measures and motion capture systems for assessing lower limb orthosis-based interventions after stroke: a systematic review

Figueiredo

Moreno

Matias

et al. 2019

Disability and Rehabilitation: Assistive Technology

View full text Add to dashboard Cite

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“…Additionally, walking stability can be improved by AFOs. Pourghasem et al 44 tested three types of rehabilitation devices (powered, posterior leg spring, and carbon AFOs) and found that the powered AFO enhances standing and walking abilities of stroke patients most. Additionally, walking with 2-degree-of-freedom (DOF) AFOs has higher stability than with 1-DOF ones.…”

Section: Medical Functionsmentioning

confidence: 99%

“…SEAs 44,52,70,93,94 are commonly configured in motor-based power transmission systems. They transform motor rotations into spring deflections.…”

Section: Design Factorsmentioning

confidence: 99%

Recent advances in wearable actuated ankle-foot orthoses: Medical effects, design, and control

Zhou

2022

Proc Inst Mech Eng H

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This paper presents a survey on recent advances of wearable actuated ankle-foot orthoses (AAFOs). First of all, their medical functions are investigated. From the short-term aspect, they lead to rectification of pathological gaits, reduction of metabolic cost, and improvement of gait performance. After AAFO-based walking training with sufficient time, free walking performance can be enhanced. Then, key design factors are studied. First, primary design parameters are investigated. Second, common actuators are analysed. Third, human-robot interaction (HRI), ergonomics, safety, and application places, are considered. In the following section, control technologies are reviewed from the aspects of rehabilitation stages, gait feature quantities, and controller characteristics. Finally, existing problems are discussed; development trends are prospected.

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“…In contrast to these devices, powered orthoses and exoskeletons are able to provide active assistance to joints, more effectively restoring motion and functional gait [31]. The design and efficacy of exoskeletons and powered orthoses are typically evaluated based on the improvement to kinematics and temporospatial parameters of gait [11,27,43]. However, as these devices have active components, they are inherently heavier than their passive counterparts, and therefore, this additional mass is expected to have some adverse effect on kinetics during walking [25,28].…”

Section: Introductionmentioning

confidence: 99%

Effects of powered ankle–foot orthoses mass distribution on lower limb muscle forces—a simulation study

Marconi

Gopalai

Chauhan

2023

Med Biol Eng Comput

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This simulation study aimed to explore the effects of mass and mass distribution of powered ankle–foot orthoses, on net joint moments and individual muscle forces throughout the lower limb. Using OpenSim inverse kinematics, dynamics, and static optimization tools, the gait cycles of ten subjects were analyzed. The biomechanical models of these subjects were appended with ideal powered ankle–foot orthoses of different masses and actuator positions, as to determine the effect that these design factors had on the subject’s kinetics during normal walking. It was found that when the mass of the device was distributed more distally and posteriorly on the leg, both the net joint moments and overall lower limb muscle forces were more negatively impacted. However, individual muscle forces were found to have varying results which were attributed to the flow-on effect of the orthosis, the antagonistic pairing of muscles, and how the activity of individual muscles affect each other. It was found that mass and mass distribution of powered ankle–foot orthoses could be optimized as to more accurately mimic natural kinetics, reducing net joint moments and overall muscle forces of the lower limb, and must consider individual muscles as to reduce potentially detrimental muscle fatigue or muscular disuse. Graphical Abstract OpenSim modelling method to explore the effect of mass and mass distribution on muscle forces and joint moments, showing potential mass positioning and the effects of these positions, mass, and actuation on the muscle force integral.

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The effect of a powered ankle foot orthosis on walking in a stroke subject: a case study

Cited by 9 publications

References 19 publications

Outcome measures and motion capture systems for assessing lower limb orthosis-based interventions after stroke: a systematic review

Outcome measures and motion capture systems for assessing lower limb orthosis-based interventions after stroke: a systematic review

Recent advances in wearable actuated ankle-foot orthoses: Medical effects, design, and control

Effects of powered ankle–foot orthoses mass distribution on lower limb muscle forces—a simulation study

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