Biomechanical Evaluation of the Combination of Bilateral Stance-Control Knee-Ankle-Foot Orthoses and a Reciprocating Gait Orthosis in an Adult With a Spinal Cord Injury

Background:The advanced reciprocating gait orthosis (ARGO) has a rigid structure which provides restricted movement at the hip, knee, and ankle joints and incorporates a pelvic section with an extended section in the lumbar region. Healthy subjects, when walking with an RGO in situ, could feasibly demonstrate the level of limitation in movement imposed by ARGO-assisted ambulation.Objective:The aim of this study was to compare the function of the advanced reciprocating gait orthosis when fitted with the dorsiflexion-assist ankle–foot orthoses on temporal–spatial parameters and kinematics of walking in both able-bodied people and those with spinal cord injury.Study design:Quasi experimental design.Methods:Data were acquired from six able-bodied and four spinal cord injury subjects who used an advanced reciprocating gait orthosis which incorporated dorsiflexion-assist ankle–foot orthoses. Kinematics and temporal–spatial parameters were calculated and compared.Results:All able-bodied individuals walked with speeds which were only approximately one-third that of when walking without an orthosis. The mean step length and cadence were both reduced by 48% and 6%, respectively. There were significant differences in hip, knee, and ankle joint range of motions between normal walking and walking with the advanced reciprocating gait orthosis both in able-bodied subjects and patients with spinal cord injury. There were also significant differences in the speed of walking, cadence, step length, hip range of motion, and ankle range of motion when using the advanced reciprocating gait orthosis between the two groups.Conclusion:Temporal–spatial parameters and lower limb sagittal plane kinematics of walking were altered compared to normal walking, especially when spinal cord injury subjects walked with the advanced reciprocating gait orthosis compared to the able-bodied subjects.Clinical relevanceTo produce an improvement in RGO function, an increase in walking performance should involve attention to improvement of hip, knee, and ankle joint kinematics, which differs significantly from normal walking.

Download Full-text

Comparison of the effects of solid versus hinged ankle foot orthoses on select temporal gait parameters in patients with incomplete spinal cord injury during treadmill walking

Prosthetics and Orthotics International ◽

10.1177/0309364612448511 ◽

2012 ◽

Vol 37 (1) ◽

pp. 70-75 ◽

Cited By ~ 4

Author(s):

Mokhtar Arazpour ◽

Hamid Reza Tajik ◽

Gholamreza Aminian ◽

Monireh Ahmadi Bani ◽

Farhad Tabatabai Ghomshe ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Step Length ◽

Foot Orthoses ◽

Incomplete Spinal Cord Injury ◽

Gait Parameters ◽

Significant Difference ◽

Cord Injury ◽

Ankle Foot Orthoses ◽

The Mean

Background:Ankle foot orthoses (AFOs) are usually used for patients with incomplete spinal cord injury (ISCI) to provide support in walking.Objectives:The aim of this study was to compare the effect of AFOs, with and without ankle hinges, on specific gait parameters during treadmill training by subjects with ISCI.Study Design:Quasi-experimental.Methods:Five patients with ISCI at the thoracic level participated in this study. Gait evaluation was performed when walking 1) barefoot 2) wearing a solid AFO and 3) wearing a hinged AFO.Results:The mean step length when walking barefoot was 26.3 ± 16.37cm compared to 31.3 ± 17.27 cm with a solid AFO and 28.5 ± 15.86 cm with a hinged AFO. The mean cadence for walking barefoot was 61.59 ± 25.65 steps/min. compared to 50.94 ± 22.36 steps/min. with a solid AFO and 56.25 ± 24.44 steps/min with a hinged AFO. Significant differences in cadence and step length during walking were only demonstrated between the barefoot condition and when wearing a solid AFO. Significant difference was not observed between conditions in mean of ankle range of motion.Conclusion:The solid AFO was the only condition which improved cadence and step length in patients during ISCI gait training.Clinical relevanceA solid AFO could be used permanently to compensate for impaired ankle function or it could be used while retraining stepping.

Download Full-text

Effects of Two Different Hip-Knee-Ankle-Foot Orthoses on Postural Stability in Subjects with Spinal Cord Injury: A Pilot Study

Asian Spine Journal ◽

10.31616/asj.2017.0283 ◽

2019 ◽

Vol 13 (1) ◽

pp. 96-102

Author(s):

Mohammad Samadian ◽

Monireh Ahmadi Bani ◽

Navid Golchin ◽

Mohammad Ali Mardani ◽

John S. Head ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Pilot Study ◽

Postural Stability ◽

Foot Orthoses ◽

Cord Injury ◽

Ankle Foot Orthoses

Download Full-text

Gait evaluation of the advanced reciprocating gait orthosis with solid versus dorsi flexion assist ankle foot orthoses in paraplegic patients

Prosthetics and Orthotics International ◽

10.1177/0309364612457704 ◽

2012 ◽

Vol 37 (2) ◽

pp. 161-167 ◽

Cited By ~ 13

Author(s):

Monireh Ahmadi Bani ◽

Mokhtar Arazpour ◽

Farhad Tabatabai Ghomshe ◽

Mohammad Ebrahim Mousavi ◽

Stephen William Hutchins

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Ankle Joint ◽

Neurological Injury ◽

Foot Orthoses ◽

Gait Parameters ◽

Cord Injury ◽

Ankle Foot Orthoses ◽

Quasi Experimental ◽

The Mean

Background:Mechanical orthoses are used for standing and walking after neurological injury. Most orthoses such as the advanced reciprocating gait orthosis typically use solid ankle–foot orthoses.Objectives:The goal of this study was to test the effects of ankle dorsiflexion assistance in patients with spinal cord injury when ambulating with an advanced reciprocating gait orthosis compared to walking with fixed ankles.Study Design:Quasi-experimental.Methods:Four patients with spinal cord injury were fitted with an advanced reciprocating gait orthosis equipped with solid and dorsiflexion assist-type ankle–foot orthoses and walked at their self-selected speed. Joint angles and spatial–temporal parameters were measured and analyzed.Results:The mean walking speed and stride length were both significantly increased along with cadence by the volunteer subjects when ambulating using the advanced reciprocating gait orthosis fitted with dorsiflexion assist ankle–foot orthoses compared to the advanced reciprocating gait orthosis with solid ankle–foot orthoses. The mean ankle joint ranges of motion were significantly increased when walking with the advanced reciprocating gait orthosis with dorsiflexion assist ankle–foot orthoses compared to when using the advanced reciprocating gait orthosis with the solid ankle–foot orthoses. Knee joint ranges of motion were reduced, and hip joint ranges of motion were increased but not significantly.Conclusion:The advanced reciprocating gait orthosis fitted with the dorsiflexion assist ankle–foot orthoses had the effect of improving gait parameters when compared to the advanced reciprocating gait orthosis with solid ankle–foot orthoses.Clinical relevanceThe advanced reciprocating gait orthosis with dorsiflexion assist ankle–foot orthoses has the potential to improve hip and ankle joint kinematics and the temporal–spatial parameters of gait in spinal cord injury patients’ walking.

Download Full-text

Biomechanical evaluation of wrist-driven flexor hinge orthosis in persons with spinal cord injury

The Journal of Rehabilitation Research and Development ◽

10.1682/jrrd.2012.10.0189 ◽

2013 ◽

Vol 50 (8) ◽

Cited By ~ 3

Author(s):

Yeoun-Seung Kang ◽

Yoon-Ghil Park ◽

Bum-Suk Lee ◽

Hyung-Soon Park

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cord Injury ◽

Biomechanical Evaluation

Download Full-text

Manufacturing and analysis of carbon fiber knee ankle foot orthosis

International Journal of Engineering & Technology ◽

10.14419/ijet.v7i4.17315 ◽

2018 ◽

Vol 7 (4) ◽

pp. 2236 ◽

Cited By ~ 5

Author(s):

Ayad M. Takhakh ◽

Saif M. Abbas

Keyword(s):

Mechanical Properties ◽

Spinal Cord ◽

Carbon Fiber ◽

Tensile Tests ◽

Foot Orthoses ◽

Well Control ◽

Ankle Foot Orthosis ◽

Cord Injury ◽

Ankle Foot Orthoses ◽

Foot Orthosis

Knee ankle foot orthoses (KAFOs) are used by paraplegia patients with low level spinal cord injury and having well control of the stem muscles. Four layers of carbon fiber with C- orthocryl lamination resin are used for manufacturing the knee ankle foot orthoses in this work. The mechanical properties of most of the components materials were estimated with the aid of fatigue and tensile test machines. Results of the tensile tests showed that the mechanical properties: yield stress, ultimate strength and modulus of elasticity were 92MPa, 105.7MPa and 2GPa respectively. The value of amidst pressure between the patient limb and the manufactured KAFO was measured using (F-socket) Mat scan sensor and these values of pressure were (663kPa) and (316kPa) for the thigh and calf regions respectively.

Download Full-text

Poster 362: Application of Microprocessor Stance Control Knee Ankle Foot Orthoses: A Case Series Report

PM&R ◽

10.1016/j.pmrj.2010.07.394 ◽

2010 ◽

Vol 2 ◽

pp. S160-S160

Author(s):

Weibin Yang ◽

Howard R. Burgess ◽

Gary A. Lamb ◽

Paul Lanciault ◽

Mary Perez ◽

...

Keyword(s):

Case Series ◽

Foot Orthoses ◽

Stance Control ◽

Ankle Foot Orthoses ◽

Case Series Report ◽

Control Knee ◽

Series Report

Download Full-text

The Effect of Stance Control Orthoses on Gait Characteristics and Energy Expenditure in Knee-Ankle-Foot Orthosis Users

Prosthetics and Orthotics International ◽

10.3109/03093641003773189 ◽

2010 ◽

Vol 34 (2) ◽

pp. 206-215 ◽

Cited By ~ 19

Author(s):

Priya Chantal Davis ◽

Timothy Michael Bach ◽

Darren Mark Pereira

Keyword(s):

Energy Expenditure ◽

Knee Joint ◽

Knee Flexion ◽

Foot Orthoses ◽

Gait Characteristics ◽

Stance Control ◽

Ankle Foot Orthoses ◽

Locked Knee ◽

Control Knee ◽

Walking Velocity

Stance Control knee-ankle foot orthoses (SCO) differ from their traditional locked knee counterparts by allowing free knee flexion during swing while providing stability during stance. It is widely accepted that free knee flexion during swing normalizes gait and therefore improves walking speed and reduces the energy requirements of walking. Limited research has been carried out to evaluate the benefits of SCOs when compared to locked knee-ankle foot orthoses (KAFOs). The purpose of this study was to evaluate the effectiveness of SCOs used for patients with lower limb pathology. Energy expenditure and walking velocity were measured in 10 subjects using an orthosis incorporating a Horton Stance Control knee joint. A GAITRite walkway was used to measure temporospatial gait characteristics. A Cosmed K4b2 portable metabolic system was used to measure energy expenditure and heart rate during walking. Two conditions were tested: Walking with stance control active (stance control) and walking with the knee joint locked. Ten subjects completed the GAITRite testing; nine subjects completed the Cosmed testing. Walking velocity was significantly increased in the stance control condition ( p < 0.001). There was no difference in the energy cost of walking ( p = 0.515) or physiological cost index (PCI) ( p = 0.093) between conditions. This study supports previous evidence that stance control knee-ankle foot orthoses increase walking velocity compared to locked knee devices. Contrary to expectation, the stance control condition did not decrease energy expenditure during walking.

Download Full-text