Development of a Soft Pneumatic Sock for Robot-Assisted Ankle Exercise

Deep vein thrombosis (DVT) is a severe medical condition that affects many patients around the world, where one of the main causes is commonly associated with prolonged immobilization. Current mechanical prophylaxis systems, such as the compression stockings and intermittent pneumatic compression devices, have yet to show strong efficacy in preventing DVT. The current study aimed to develop a soft pneumatic sock prototype that uses soft extension pneumatic actuators to provide assisted ankle dorsiflexion–plantarflexion motion, so as to prevent the occurrence of DVT. The prototype was evaluated for its efficacy to provide the required dorsiflexion–plantarflexion motion by donning and actuating the prototype on simulated ankle–foot models with various ankle joint stiffness values. Our results showed that the soft extension actuators in the sock prototype provided controllable assisted ankle plantarflexion through actuator extension and ankle dorsiflexion through actuator contraction, where in our study, the actuations extended to 129.9–146.8% of its original length. Furthermore, the sock was able to achieve consistent range of motion at the simulated ankle joint across different joint stiffness values (range of motion: 27.5 ± 6.0 deg). This study demonstrated the feasibility of using soft extension pneumatic actuators to provide robot-assisted ankle dorsiflexion–plantarflexion motion, which will act as an adjunct to physiotherapists to optimize therapy time for bedridden patients and therefore may reduce the risk of developing DVT.

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Relationship of Body Mass Index, Ankle Dorsiflexion, and Foot Pronation on Plantar Fascia Thickness in Healthy, Asymptomatic Subjects

Journal of the American Podiatric Medical Association ◽

10.7547/0980379 ◽

2008 ◽

Vol 98 (5) ◽

pp. 379-385 ◽

Cited By ~ 18

Author(s):

Javier Pascual Huerta ◽

Juan Maria Alarcón García ◽

Eva Cosin Matamoros ◽

Julia Cosin Matamoros ◽

Teresa Díaz Martínez

Keyword(s):

Body Mass Index ◽

Range Of Motion ◽

Ankle Joint ◽

Body Mass ◽

Plantar Fasciitis ◽

Plantar Fascia ◽

Ankle Dorsiflexion ◽

Ankle Joint Dorsiflexion ◽

Foot Pronation ◽

Asymptomatic Subjects

Background: We sought to investigate the thickness of plantar fascia, measured by means of ultrasonographic evaluation in healthy, asymptomatic subjects, and its relationship to body mass index, ankle joint dorsiflexion range of motion, and foot pronation in static stance. Methods: One hundred two feet of 51 healthy volunteers were examined. Sonographic evaluation with a 10-MHz linear array transducer was performed 1 and 2 cm distal to its insertion. Physical examination was also performed to assess body mass index, ankle joint dorsiflexion, and degree of foot pronation in static stance. Both examinations were performed in a blinded manner. Results: Body mass index showed moderate correlation with plantar fascia thickness at the 1- and 2-cm locations. Ankle dorsiflexion range of motion showed no correlation at either location. Foot pronation showed an inverse correlation with plantar fascia thickness at the 2-cm location and no correlation at the 1-cm location. Conclusion: Body mass index and foot supination at the subtalar joint are related to increased thickness at the plantar fascia in healthy, asymptomatic subjects. Although the changes in thickness were small compared with those in patients with symptomatic plantar fasciitis, they could play a role in the mechanical properties of plantar fascia and in the development of plantar fasciitis. (J Am Podiatr Med Assoc 98(5): 379–385, 2008)

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The Reliability of a Smartphone Goniometer Application Compared With a Traditional Goniometer for Measuring Ankle Joint Range of Motion

Journal of the American Podiatric Medical Association ◽

10.7547/16-128 ◽

2019 ◽

Vol 109 (1) ◽

pp. 22-29 ◽

Cited By ~ 3

Author(s):

Motaz Abdalla Alawna ◽

Bayram H. Unver ◽

Ertugrul O. Yuksel

Keyword(s):

Range Of Motion ◽

Ankle Joint ◽

Interrater Reliability ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Ankle Dorsiflexion ◽

Data Sets ◽

Intrarater Reliability ◽

New Device ◽

Advantages And Disadvantages

Background: Evaluation of range of motion (ROM) is integral to assessment of the musculoskeletal system, is required in health fitness and pathologic conditions, and is used as an objective outcome measure. Several methods are described to check ROM, each with advantages and disadvantages. Hence, this study introduces a new device using a smartphone goniometer to measure ankle joint ROM. Objective: To test the reliability of smartphone goniometry in the ankle joint by comparing it with the universal goniometer (UG) and to assess interrater and intrarater reliability for the smartphone goniometer record (SGR) application. Methods: Fifty-eight healthy volunteers (29 men and 29 women aged 18–30 years) underwent SGR and UG measurement of ankle joint dorsiflexion and plantarflexion. Two examiners measured ankle joint ROM. Descriptive statistics were calculated for descriptive and anthropometric variables, as were intraclass correlation coefficients (ICCs). Results: There were 58 usable data sets. For measuring ankle dorsiflexion ROM, both instruments showed excellent interrater reliability: UG (ICC = 0.87) and SGR (ICC = 0.89). Intrarater reliability was excellent in both instruments in ankle dorsiflexion: UG and SGR (mean ICC = 0.91). For measuring ankle plantarflexion, both instruments showed excellent interrater reliability: UG (ICC = 0.76) and SGR (ICC = 0.82). Intrarater reliability was excellent in both instruments in ankle plantarflexion: UG (mean ICC = 0.85) and SGR (mean ICC = 0.82). Conclusions: Smartphone-based goniometers can be used to assess active ROM of the ankle joint because they can achieve a high degree of intrarater and interrater reliability.

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Design and Testing of a Prosthetic Foot With Interchangeable Custom Springs for Evaluating Lower Leg Trajectory Error, an Optimization Metric for Prosthetic Feet

Journal of Mechanisms and Robotics ◽

10.1115/1.4039342 ◽

2018 ◽

Vol 10 (2) ◽

Cited By ~ 1

Author(s):

Victor Prost ◽

Kathryn M. Olesnavage ◽

W. Brett Johnson ◽

Matthew J. Major ◽

Amos G. Winter

Keyword(s):

Range Of Motion ◽

Ankle Joint ◽

Large Scale ◽

Joint Stiffness ◽

Lower Leg ◽

Trajectory Error ◽

Prosthetic Foot ◽

Design Variables ◽

Prosthetic Feet

An experimental prosthetic foot intended for evaluating a novel design objective is presented. This objective, called the lower leg trajectory error (LLTE), enables the optimization of passive prosthetic feet by modeling the trajectory of the shank during single support for a given prosthetic foot and selecting design variables that minimize the error between this trajectory and able-bodied kinematics. A light-weight, fully characterized test foot with variable ankle joint stiffness was designed to evaluate the LLTE. The test foot can replicate the range of motion of a physiological ankle over a range of different ankle joint stiffnesses. The test foot consists of a rotational ankle joint machined from acetal resin, interchangeable U-shaped nylon springs that range from 1.5 N · m/deg to 24 N · m/deg, and a flexible nylon forefoot with a bending stiffness of 16 N · m2. The U-shaped springs were designed to support a constant moment along their length to maximize strain energy density; this feature was critical in creating a high-stiffness and high-range of motion ankle. The design performed as predicted during mechanical and in vivo testing, and its modularity allowed us to rapidly vary the ankle joint stiffness. Qualitative feedback from preliminary testing showed that this design is ready for use in large scale clinical trials to further evaluate the use of the LLTE as an optimization objective for passive prosthetic feet.

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Role of spasticity severity on the balance of post-stroke patients (Preprint)

10.2196/preprints.33237 ◽

2021 ◽

Author(s):

Ashraf Mahmoudzadeh ◽

Noureddin Nakhostin Ansari ◽

Soofia Naghdi ◽

Ehsan Ghasemi ◽

Brandon S Shaw ◽

...

Keyword(s):

Range Of Motion ◽

Ankle Joint ◽

Postural Sway ◽

Dynamic Balance ◽

Ankle Dorsiflexion ◽

Plantar Flexor ◽

Stroke Patients ◽

Timed Up And Go ◽

Balance Confidence ◽

Post Stroke

BACKGROUND Lower limb spasticity, as is common following a cerebrovascular attack (CVA) or stroke, can affect the balance and gait of patients. This then not only affects independence, and quality of life, but also increases the risk for other concerns, such as falling and an increased sedentariness, which could further affect health outcomes. OBJECTIVE We aimed to evaluate the effect of ankle plantar flexor spasticity severity on balance and to determine the relationship between the spasticity severity with ankle proprioception, passive range of motion (ROM), and balance confidence in post-stroke patients. METHODS Twenty-eight post-stroke patients were divided into two groups based on the level of ankle plantar flexor spasticity according to the Modified Modified Ashworth Scale (MMAS) as a High Spasticity Group (HSG) (MMAS>2) (n=14) or a Low Spasticity Group (LSG) (MMAS≤2) (n=14). The MMAS scores, Activities-Specific Balance Confidence Questionnaire, postural sway in the open and closed eyes conditions, timed up and go (TUG) test, ankle dorsiflexion passive range of motion (ROM), and ankle joint proprioception were measured. RESULTS No significant (p>0.05) differences were found between the LSG and HSG in terms of balance confidence, dynamic balance, and ankle dorsiflexion ROM. In addition, postural sway in the open and closed eye conditions was not significantly different in both the LSG and HSG for both the less affected and affected limbs. Similarly, posturography indicators in the open and closed eye conditions were not significantly different in both the LSG and HSG for both the less affected and affected limbs. However, ankle joint proprioception in terms of repositioning error angle was significantly (p≤0.05) better in the LSG compared to the HSG (p=0.01). There was also a significant relationship between TUG scores and balance confidence in the HSG(r=-0.55, p=0.04) CONCLUSIONS Our data suggests that several aspects of balance needs to be considered in the assessment and rehabilitation of post-stroke patients and there is a need to monitor entire patterns of activities to support wider engagement in rehabilitation activities. INTERNATIONAL REGISTERED REPORT RR2-10.2196/16045

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Design of a manual device to measure ankle joint stiffness and range of motion

Prosthetics and Orthotics International ◽

10.1177/0309364611425696 ◽

2011 ◽

Vol 35 (4) ◽

pp. 478-481 ◽

Cited By ~ 11

Author(s):

Toshiki Kobayashi ◽

Aaron KL Leung ◽

Stephen W Hutchins

Keyword(s):

Range Of Motion ◽

Ankle Joint ◽

High Reliability ◽

Intraclass Correlation ◽

Joint Stiffness ◽

Technical Note ◽

Steering Wheel ◽

Ankle Foot Orthosis ◽

Resistive Torque ◽

Rotary Plate

Background and Aim: Ankle joint stiffness and its range of motion (ROM) are commonly assessed to determine the appropriate mechanical characteristics required in an effective ankle-foot orthosis (AFO) prescription. The aim of this technical note is to present the design of a manual device that enables their convenient measurement in the clinical setting and to demonstrate its reliability.Technique: The manual device was designed with a torquemeter, a potentiometer, a steering wheel, a rotary plate, and a foot plate. The measurement of resistive torque at 0° (neutral), 5° (dorsiflexion) and 10° (dorsiflexion) ankle angular positions demonstrated the high reliability of the device with Intraclass Correlation Coefficient (ICC) (1,k) values over 0.97.Discussion: Quantitative measurement of ankle joint stiffness and ROM by this manual device would provide objective information that could potentially assist AFO prescriptions. A future study should investigate how to incorporate the measurement obtained from the device into the prescription of an AFO.

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Sagittal Plane Range of Motion of the Pediatric Ankle Joint

Journal of the American Podiatric Medical Association ◽

10.7547/0960418 ◽

2006 ◽

Vol 96 (5) ◽

pp. 418-422 ◽

Cited By ~ 11

Author(s):

Angela M. Evans ◽

Sheila D. Scutter

Keyword(s):

Range Of Motion ◽

Ankle Joint ◽

Interrater Reliability ◽

Sagittal Plane ◽

Ankle Dorsiflexion ◽

Healthy Individuals

Measurement of ankle dorsiflexion is a routine part of the podiatric examination of children, yet the reliability of this measure is largely unknown in healthy individuals. This study assessed the intrarater and interrater reliability of the first and second resistance levels of sagittal ankle range of motion in 4- to 6-year-old children. The results show that measures of ankle dorsiflexion in children are highly variable among examiners, and, in general, gastrocnemius range of motion is more reliable than soleal range of motion. (J Am Podiatr Med Assoc 96(5): 418–422, 2006)

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INFLUENCE OF FOOT INSOLE ON THE GAIT PERFORMANCE IN SUBJECTS WITH FLAT FOOT DISORDER

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519419500507 ◽

2019 ◽

Vol 19 (06) ◽

pp. 1950050

Author(s):

M. T. KARIMI ◽

R. B. TAHMASEBI ◽

B. SATVATI ◽

F. FATOYE

Keyword(s):

Range Of Motion ◽

Ankle Joint ◽

Lower Limb ◽

Walking Speed ◽

Force Plate ◽

Flat Foot ◽

Gait Performance ◽

Positive Effects ◽

Significant Difference ◽

Foot Disorder

Flat foot is the most common foot disorder that influences the alignment of the lower limb structure. It is controversial whether the use of foot insole influences kinetic and kinematic of the leg or not. Therefore, this study investigated the influence of foot insole on the gait performance in subjects with flat foot disorder. A group of flat foot subject was recruited into this study (the number of subjects was 15). The motion of the leg joints was determined using the Qualysis motion analysis system. Moreover, the force applied on the lower limb was recorded by a Kistler force plate. The range of motion of the lower limb joints, the moments applied on the lower limb joints and force transmitted through the leg were the parameters used in this study. The difference between these parameters during walking with and without insole was evaluated using the paired [Formula: see text]-test. Significant value was set at [Formula: see text]. There was no significant difference between the range of motion of ankle joint while walking with and without insole. However, the medial directed force applied on the leg decreased significantly [Formula: see text]. The use of foot insole did not influence the moments transmitted through the hip and knee joints. The walking speed of the subjects improved while walking with foot insole. Use of foot insole influenced the magnitude of the force applied on the leg and the adductor moment of ankle joint due to its influence on foot alignment. As the walking speed of the improved subjects follows the use of insole, it can be concluded that it may have a positive effects on the performance of flat foot subjects.

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Effects of the Suboccipital Muscle Inhibition Technique on the Range of Motion of the Ankle Joint and Balance According to Its Application Duration: A Randomized Controlled Trial

Healthcare ◽

10.3390/healthcare9060646 ◽

2021 ◽

Vol 9 (6) ◽

pp. 646

Author(s):

Han-Sol Kang ◽

Hyung-Wook Kwon ◽

Di-gud Kim ◽

Kwang-Rak Park ◽

Suk-Chan Hahm ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Range Of Motion ◽

Ankle Joint ◽

Controlled Trial ◽

Balance Test ◽

Randomized Controlled ◽

Active Range Of Motion ◽

Before And After ◽

Muscle Inhibition ◽

Inhibition Technique

This study aimed to investigate the effects of suboccipital muscle inhibition technique (SMIT) on active range of motion (AROM) of the ankle joint, lunge angle (LA), and balance in healthy adults, according to the duration of its application. A total of 80 participants were randomly allocated to the 4-min suboccipital muscle inhibition (SMI) group (SMI_4M, n = 20), 8-min SMI group (n = 20), 4-min sham-SMI (SSMI) group (n = 20), and 8-min SSMI group (n = 20). Accordingly, the SMIT and sham SMIT were applied for 4 min or 8 min in the respective groups. AROM of dorsiflexion and LA were assessed, and a single leg balance test (SLBT) was performed before and after the intervention. AROM (4 min, p < 0.001; 8 min, p < 0.001), LA (4 min, p < 0.001; 8 min, p < 0.001), and SLBT (4 min, p < 0.001; 8 min, p < 0.001) significantly improved after SMI application. Compared with the SSMI group, the SMI group showed a significant increase in AROM (p < 0.001), LA (p < 0.001), and SLBT (p < 0.001). Except for SLBT (p = 0.016), there were no significant interactions between intervention and application duration. The results suggest that the SMIT, at durations of both 4 and 8 min, could be effective tools for improving AROM, LA, and balance.

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