Walking ability and energy expenditure in post-stroke patients with a ankle-foot orthosis

Background:Ankle–foot orthoses could be utilized both with and without shoes. While several studies have shown that ankle–foot orthoses improve gait abilities in hemiplegic patients, it remains unclear whether they should be used with shoes or without.Objectives:The study purpose was to compare the effect of standard shoes and rocker shoes on functional mobility in post-stroke hemiplegic patients utilizing ankle–foot orthosis.Study design:Randomized clinical study.Methods:Thirty post-stroke hemiplegic patients participated in this study randomly assigned to two groups. Group I received standard shoes + ankle–foot orthosis and group II were provided with rocker shoes + ankle–foot orthosis. Their functional mobility and energy expenditure parameters including timed up and go, timed up stairs, timed down stairs, preferred walking speed, and oxygen (O2) cost (mL/kg/m) were measured.Results:In group I, no significant changes were seen in outcome measures after wearing standard shoes. While in group II, O2cost and timed up and go time significantly decreased, and preferred walking speed increased when patients wore rocker shoes. Also, there was a significant difference between rocker shoes and standard shoes in improvement of timed up and go, preferred walking speed, and O2cost.Conclusion:When patients using ankle–foot orthosis wore rocker shoes, their functional mobility improved and oxygen cost diminished. Also, rocker shoes was significantly more effective than standard shoes in improving functional mobility parameters.Clinical relevanceThis study suggests that in post-stroke hemiplegic patients using ankle–foot orthosis, wearing rocker shoes can lead to much more improved functional mobility and decreased energy expenditure compared to ankle–foot orthosis only. Thus, in stroke patients, the combination of ankle–foot orthosis-rocker shoes is recommended for both rehabilitation programs and ankle–foot orthosis efficacy investigations.

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Functional electrical stimulation compared with ankle-foot orthosis in subacute post stroke patients with foot drop: A pilot study

Assistive Technology ◽

10.1080/10400435.2019.1579269 ◽

2019 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Naama Karniel ◽

Eitan Raveh ◽

Isabella Schwartz ◽

Sigal Portnoy

Keyword(s):

Electrical Stimulation ◽

Pilot Study ◽

Functional Electrical Stimulation ◽

Foot Drop ◽

Stroke Patients ◽

Ankle Foot Orthosis ◽

Post Stroke ◽

Foot Orthosis

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A Review on the Control of the Mechanical Properties of Ankle Foot Orthosis for Gait Assistance

Actuators ◽

10.3390/act8010010 ◽

2019 ◽

Vol 8 (1) ◽

pp. 10 ◽

Cited By ~ 3

Author(s):

Dimas Adiputra ◽

Nurhazimah Nazmi ◽

Irfan Bahiuddin ◽

Ubaidillah Ubaidillah ◽

Fitrian Imaduddin ◽

...

Keyword(s):

Mechanical Properties ◽

Control Strategies ◽

Estimation Method ◽

Adaptive Controller ◽

Foot Drop ◽

Stroke Patients ◽

Gait Control ◽

Ankle Foot Orthosis ◽

Post Stroke ◽

Foot Orthosis

In the past decade, advanced technologies in robotics have been explored to enhance the rehabilitation of post-stroke patients. Previous works have shown that gait assistance for post-stroke patients can be provided through the use of robotics technology in ancillary equipment, such as Ankle Foot Orthosis (AFO). An AFO is usually used to assist patients with spasticity or foot drop problems. There are several types of AFOs, depending on the flexibility of the joint, such as rigid, flexible rigid, and articulated AFOs. A rigid AFO has a fixed joint, and a flexible rigid AFO has a more flexible joint, while the articulated AFO has a freely rotating ankle joint, where the mechanical properties of the AFO are more controllable compared to the other two types of AFOs. This paper reviews the control of the mechanical properties of existing AFOs for gait assistance in post-stroke patients. Several aspects that affect the control of the mechanical properties of an AFO, such as the controller input, number of gait phases, controller output reference, and controller performance evaluation are discussed and compared. Thus, this paper will be of interest to AFO researchers or developers who would like to design their own AFOs with the most suitable mechanical properties based on their application. The controller input and the number of gait phases are discussed first. Then, the discussion moves forward to the methods of estimating the controller output reference, which is the main focus of this study. Based on the estimation method, the gait control strategies can be classified into subject-oriented estimations and phase-oriented estimations. Finally, suggestions for future studies are addressed, one of which is the application of the adaptive controller output reference to maximize the benefits of the AFO to users.

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