scholarly journals Acute and mid-term (six-week) effects of an ankle-foot-orthosis on biomechanical parameters, clinical outcomes and physical activity in knee osteoarthritis patients with varus malalignment

2018 ◽  
Vol 62 ◽  
pp. 297-302 ◽  
Author(s):  
Maik Sliepen ◽  
Elsa Mauricio ◽  
Dieter Rosenbaum
Keyword(s):  
Physical Activity ◽  
Knee Osteoarthritis ◽  
Clinical Outcomes ◽  
Varus Malalignment ◽  
Ankle Foot Orthosis ◽  
Biomechanical Parameters ◽  
Foot Orthosis

scholarly journals Effectiveness of an ankle–foot orthosis on walking in patients with stroke: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoo Jin Choo ◽  
Min Cheol Chang
Keyword(s):  
Stride Length ◽  
Walking Speed ◽  
Sagittal Plane ◽  
Meta Analysis ◽  
Step Length ◽  
Stride Time ◽  
Plane Angle ◽  
Ankle Foot Orthosis ◽  
Biomechanical Parameters ◽  
Foot Orthosis

AbstractWe conducted a meta-analysis to investigate the effectiveness of ankle–foot orthosis (AFO) use in improving gait biomechanical parameters such as walking speed, mobility, and kinematics in patients with stroke with gait disturbance. We searched the MEDLINE (Medical Literature Analysis and Retrieval System Online), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, Embase, and Scopus databases and retrieved studies published until June 2021. Experimental and prospective studies were included that evaluated biomechanics or kinematic parameters with or without AFO in patients with stroke. We analyzed gait biomechanical parameters, including walking speed, mobility, balance, and kinematic variables, in studies involving patients with and without AFO use. The criteria of the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate the methodological quality of the studies, and the level of evidence was evaluated using the Research Pyramid model. Funnel plot analysis and Egger’s test were performed to confirm publication bias. A total of 19 studies including 434 participants that reported on the immediate or short-term effectiveness of AFO use were included in the analysis. Significant improvements in walking speed (standardized mean difference [SMD], 0.50; 95% CI 0.34–0.66; P < 0.00001; I2, 0%), cadence (SMD, 0.42; 95% CI 0.22–0.62; P < 0.0001; I2, 0%), step length (SMD, 0.41; 95% CI 0.18–0.63; P = 0.0003; I2, 2%), stride length (SMD, 0.43; 95% CI 0.15–0.71; P = 0.003; I2, 7%), Timed up-and-go test (SMD, − 0.30; 95% CI − 0.54 to − 0.07; P = 0.01; I2, 0%), functional ambulation category (FAC) score (SMD, 1.61; 95% CI 1.19–2.02; P < 0.00001; I2, 0%), ankle sagittal plane angle at initial contact (SMD, 0.66; 95% CI 0.34–0.98; P < 0.0001; I2, 0%), and knee sagittal plane angle at toe-off (SMD, 0.39; 95% CI 0.04–0.73; P = 0.03; I2, 46%) were observed when the patients wore AFOs. Stride time, body sway, and hip sagittal plane angle at toe-off were not significantly improved (p = 0.74, p = 0.07, p = 0.07, respectively). Among these results, the FAC score showed the most significant improvement, and stride time showed the lowest improvement. AFO improves walking speed, cadence, step length, and stride length, particularly in patients with stroke. AFO is considered beneficial in enhancing gait stability and ambulatory ability.

scholarly journals Passive-dynamic ankle-foot orthosis improves medium-term clinical outcomes after severe lower extremity trauma

2018 ◽  
Vol 165 (5) ◽  
pp. 330-337 ◽  
Author(s):  
Peter Ladlow ◽  
N Bennett ◽  
R Phillip ◽  
S Dharm-Datta ◽  
L McMenemy ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Clinical Outcomes ◽  
Limb Salvage ◽  
Care Pathway ◽  
Medium Term ◽  
Rehabilitation Care ◽  
Ankle Foot Orthosis ◽  
Lower Extremity Trauma ◽  
Extremity Trauma ◽  
Foot Orthosis

IntroductionIndividuals with delayed below-knee amputation have previously reported superior clinical outcomes compared with lower limb reconstruction. The UK military have since introduced a passive-dynamic ankle-foot orthosis (PDAFO) into its rehabilitation care pathway to improve limb salvage outcomes. The aims were to determine if wearing a PDAFO improves medium-term clinical outcomes and what influence does multidisciplinary team (MDT) rehabilitation have after PDAFO fitting? Also, what longitudinal changes in clinical outcomes occur with MDT rehabilitation and how do these results compare with patients with previous lower extremity trauma discharged prior to PDAFO availability?MethodsWe retrospectively evaluated levels of mobility, activities of daily living, anxiety, depression and pain in a heterogeneous group of 23 injured UK servicemen 34±11 months after PDAFO provision. We also retrospectively analysed 16 patients across four time points (pre-PDAFO provision, first, second and final inpatient admissions post-PDAFO provision) using identical outcome measures, plus the 6 min walk test.ResultsOutcomes were compared with previous below-knee limb salvage and amputees. Before PDAFO, 74% were able to walk and 4% were able to run independently. At follow-up, this increased to 91% and 57%, respectively. Mean depression and anxiety scores remained stable over time (p>0.05). After 3 weeks, all patients could walk independently (pre-PDAFO=31%). Mean 6 min walk distance significantly increased from 440±75 m (pre-PDAFO) to 533±68 m at last admission (p=0.003). The ability to run increased from 6% to 44% after one admission.ConclusionsAll functional and most psychosocial outcomes in PDAFO users were superior to previous limb salvage and comparable to previous below-knee amputees. The PDAFO facilitated favourable short-term and medium-term changes in all clinical outcome measurements.

scholarly journals Effect of an ankle–foot orthosis on knee joint mechanics: A novel conservative treatment for knee osteoarthritis

2013 ◽  
Vol 38 (6) ◽  
pp. 481-491 ◽  
Author(s):  
Cynthia H Fantini Pagani ◽  
Steffen Willwacher ◽  
Rita Benker ◽  
Gert-Peter Brüggemann
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Frontal Plane ◽  
Knee Adduction Moment ◽  
Varus Alignment ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Ankle Foot Orthosis ◽  
Lever Arm ◽  
Foot Orthosis

Background: Several conservative treatments for medial knee osteoarthritis such as knee orthosis and laterally wedged insoles have been shown to reduce the load in the medial knee compartment. However, those treatments also present limitations such as patient compliance and inconsistent results regarding the treatment success. Objective: To analyze the effect of an ankle–foot orthosis on the knee adduction moment and knee joint alignment in the frontal plane in subjects with knee varus alignment. Study design: Controlled laboratory study, repeated measurements. Methods: In total, 14 healthy subjects with knee varus alignment were analyzed in five different conditions: without orthotic, with laterally wedged insoles, and with an ankle–foot orthosis in three different adjustments. Three-dimensional kinetic and kinematic data were collected during gait analysis. Results: Significant decreases in knee adduction moment, knee lever arm, and joint alignment in the frontal plane were observed with the ankle–foot orthosis in all three different adjustments. No significant differences could be found in any parameter while using the laterally wedged insoles. Conclusion: The ankle–foot orthosis was effective in reducing the knee adduction moment. The decreases in this parameter seem to be achieved by changing the knee joint alignment and thereby reducing the knee lever arm in the frontal plane. Clinical relevance This study presents a novel approach for reducing the load in the medial knee compartment, which could be developed as a new treatment option for patients with medial knee osteoarthritis.

Abstract 13282: Patients With Peripheral Artery Disease Perceptions of an Ankle Foot Orthosis: A Comparison by Physical Activity Level

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Danae Dinkel ◽  
Mahdi Hassan ◽  
Holly Despiegelaere ◽  
JASON Johanning ◽  
Iraklis I Pipinos ◽  
...  
Keyword(s):  
Physical Activity ◽  
Peripheral Artery Disease ◽  
Physical Activity Level ◽  
Grocery Store ◽  
Activity Level ◽  
Peripheral Artery ◽  
Ankle Foot Orthosis ◽  
Artery Disease ◽  
Baseline Physical Activity ◽  
Foot Orthosis

Introduction: Peripheral Artery Disease (PAD) restricts blood flow to the legs. Its most common manifestation is claudication, a severe impairment of physical activity produced by ischemia-related leg pain and tiredness during walking. We are conducting a trial to evaluate the possibility that an ankle foot orthosis could reduce claudication symptoms and increase the physical activity of patients with PAD. The perceptions of patients with PAD on wearing the ankle foot orthosis and how they vary by baseline physical activity level are unknown. Therefore, this study explored the perceptions of patients with PAD while using an ankle foot orthosis and if these perceptions varied by level of physical activity. Hypothesis: We hypothesize that those who are more physically active will perceive more benefits as a result of using the ankle foot orthosis. Methods: Participants (n=21) wore an ankle foot orthosis for 3 months. Baseline median step count was used to divide patients into high (n=10) or low (n=11) active groups. Semi-structured interviews were conducted at midpoint and post. Data were analyzed using a summative content analysis. Results: Patients averaged 3233 ± 1523 steps/day with a median of 3137 steps/day at baseline. 45% of participants’ initial responses described a positive perception of their time wearing the ankle foot orthosis. 71.4% of participants reported an overall positive impact of wearing the ankle foot orthosis, primarily being able to walk further. Comparison by baseline physical activity level revealed 36.4% of participants with low physical activity reported seeing improvements in daily tasks (walking in the grocery store) versus 10% of those with high physical activity. Conclusions: In conclusion, our interview data demonstrate that perceived quality of physical activity in patients with PAD improved with the use of the ankle foot orthosis. Contrary to our hypothesis, minimal differences in perceptions of ankle foot orthosis use were found between patients with low versus high baseline physical activity levels.

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