The influence of ankle joint mobility when using an orthosis on stability in patients with spinal cord injury: a pilot study

Abstract

Objectives: Perceived risk of falling is an important factor for people with spinal cord injury (SCI). This study investigated the influence of ankle joint motion on postural stability and walking in people with SCI when using an orthosis. Methods: Volunteer subjects with SCI (n ¼ 5) participated in this study. Each subject was fitted with an advanced reciprocating gait orthosis (ARGO) equipped with either solid or dorsiflexion-assist type ankle-foot orthosis (AFOs) and walked at their self-selected speed along a flat walkway to enable the comparison of walking speed, cadence and endurance. A force plate system and a modified Falls Efficacy Scale (MFES) were utilized to measure postural sway and the perceived fear of falling, respectively. Results: There were significant differences in the mean MFES scores between two types of orthosis (P ¼ 0.023). When using two crutches, there was no significant difference in static standing postural sway in the medio-lateral (M/L) direction (P ¼ 0.799), but significant difference in the antero-posterior (A/P) direction (P ¼ 0.014). However, during single crutch support, there was a significant difference in both M/L (P ¼ 0.019) and A/P (P ¼ 0.022) directions. Walking speed (7%) and endurance (5%) significantly increased when using the ARGO with dorsi flexion assisted AFOs. There was no significant deference between two types of orthoses in cadence (P ¼ 0.54). Conclusions: Using an ARGO with dorsiflexion-assisted AFOs increased the fear of falling, but improved static postural stability and increased walking speed and endurance, and should therefore be considered as an effective orthosis during the rehabilitation of people with SCI.

An immediate effect of custom-made ankle foot orthoses on postural stability in older adults

“…As the reach was in the anterior-posterior direction, we assume that AFO flexible gauntlet design did not restrict forward reach, but improved the ankle hip co-ordination. Similar results of improved postural stability and walking (Arazpour et al, 2013;Menotti et al, 2014) were found in other older adult populations as well when using a flexible AFO design.…”

The effect of ankle joint mobility when using an isocentric reciprocating gait orthosis (IRGO) on energy consumption in people with spinal cord injury: preliminary results

“…29 Also, in using a AFO, Arazpour et al demonstrated that using an ARGO with dorsiflexion-assisted AFOs increased the fear of falling, but did improve static postural stability and increased walking speed and endurance. 18 Increase of temporal spatial parameters and Figure 1. IRGO overall view and dorsiflexion-assisted ankle joints used in this study.…”

“…The 1 use of reciprocal gait orthoses (RGOs) when utilizing dorsiflexionassisted AFOs to walk has a potential to decrease the energy consumption based on increased endurance compared with those with solid AFOs. 18 However, the effect of ankle joint mobility on energy consumption is not clear in SCI patients. Based on the important role of the ankle joint during walking and improvement of walking parameters via movable ankle joints in using mechanical orthosis, we hypothesized that ankle joint mobility would have a positive effect on reducing energy consumption during walking with an IRGO.…”

Role of Gait Training in Recovery of Standing and Walking in Subjects with Spinal Cord Injury

“…Orthotic training in SCI subjects can be reduced fatigue and fear of falling and increased the stepping [61]. It was announced that after training program, SCI subjects had walking ability and performance of activity of daily living.…”