Defining the Mechanical Properties of a Spring-hinged Ankle Foot Orthosis to Assess its Potential Use in Children With Spastic Cerebral Palsy

2014 ◽  
Vol 30 (6) ◽  
pp. 728-731 ◽  
Author(s):  
Yvette L. Kerkum ◽  
Merel-Anne Brehm ◽  
Annemieke I. Buizer ◽  
Josien C. van den Noort ◽  
Jules G. Becher ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Cerebral Palsy ◽  
Knee Flexion ◽  
Spastic Cerebral Palsy ◽  
Gait Performance ◽  
Ankle Foot Orthosis ◽  
The Moment ◽  
Potential Use ◽  
Foot Orthosis ◽  
Walking Energy Cost

A rigid ventral shelf ankle foot orthosis (AFO) may improve gait in children with spastic cerebral palsy (SCP) whose gait is characterized by excessive knee flexion in stance. However, these AFOs can also impede ankle range of motion (ROM) and thereby inhibit push-off power. A more spring-like AFO can enhance push-off and may potentially reduce walking energy cost. The recent development of an adjustable spring-hinged AFO now allows adjustment of AFO stiffness, enabling tuning toward optimal gait performance. This study aims to quantify the mechanical properties of this spring-hinged AFO for each of its springs and settings. Using an AFO stiffness tester, two AFO hinges and their accompanying springs were measured. The springs showed a stiffness range of 0.01−1.82 N·m·deg−1. The moment-threshold increased with increasing stiffness (1.13–12.1 N·m), while ROM decreased (4.91–16.5°). Energy was returned by all springs (11.5–116.3 J). These results suggest that the two stiffest available springs should improve joint kinematics and enhance push-off in children with SCP walking with excessive knee flexion.

scholarly journals The Effects of Varying Ankle Foot Orthosis Stiffness on Gait in Children with Spastic Cerebral Palsy Who Walk with Excessive Knee Flexion

PLoS ONE ◽  
2015 ◽  
Vol 10 (11) ◽  
pp. e0142878 ◽  
Author(s):  
Yvette L. Kerkum ◽  
Annemieke I. Buizer ◽  
Josien C. van den Noort ◽  
Jules G. Becher ◽  
Jaap Harlaar ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Knee Flexion ◽  
Spastic Cerebral Palsy ◽  
Ankle Foot Orthosis ◽  
Foot Orthosis

Immediate Effects of the Dorsiflexion Angle of Hinged Ankle-foot Orthosis on the Spatiotemporal Gait Parameters of Children With Spastic Cerebral Palsy

2021 ◽  
Author(s):  
IlHyun Son ◽  
GyuChang Lee
Keyword(s):  
Cerebral Palsy ◽  
Stride Length ◽  
Step Length ◽  
Gait Velocity ◽  
Spastic Cerebral Palsy ◽  
Spastic Diplegia ◽  
Ankle Foot Orthosis ◽  
Gait Parameters ◽  
Children With Cerebral Palsy ◽  
Foot Orthosis

Abstract Background: It has been reported the effects of a hinged ankle-foot orthosis on the gait ability of children with cerebral palsy. However, no studies investigated the effects of the dorsiflexion angle of the hinged ankle-foot orthosis on the spatiotemporal gait parameters of children with cerebral palsy. This study aimed to investigate the immediate effects of a 10° dorsiflexion inducing ankle-foot orthosis the spatiotemporal gait parameters of children with spastic diplegia compared to barefoot and a hinged ankle-foot orthosis.Methods: This study was cross-over design. 10 children with spastic diplegia were walked with barefoot, a hinged ankle-foot orthosis, and a 10° dorsiflexion inducing ankle-foot orthosis. GAITRite was used to collect the spatiotemporal gait parameters including gait velocity, cadence, step length, stride length, single leg support, and double leg support. Results: It showed that a 10° dorsiflexion inducing ankle-foot orthosis significantly improved the gait velocity, cadence, step length, stride length, single leg support, and double leg support than barefoot and a hinged ankle-foot orthosis (p<.05). Conclusion: The results of this study implied that a 10° dorsiflexion inducing ankle-foot orthosis could improve the gait ability of children with spastic diplegia more than barefoot or a hinged ankle-foot orthosis. High quality future studies will need to examine the effects of hinged ankle-foot orthosis on gait ability according to dorsiflexion angles.

Acclimatization of the gait pattern to wearing an ankle–foot orthosis in children with spastic cerebral palsy

2015 ◽  
Vol 30 (6) ◽  
pp. 617-622 ◽  
Author(s):  
Yvette L. Kerkum ◽  
Merel-Anne Brehm ◽  
Kim van Hutten ◽  
Josien C. van den Noort ◽  
Jaap Harlaar ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Gait Pattern ◽  
Spastic Cerebral Palsy ◽  
Ankle Foot Orthosis ◽  
Foot Orthosis

scholarly journals The effect of floor reaction ankle foot orthosis on postural control in children with spastic cerebral palsy

2011 ◽  
Vol 36 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Mahmood Bahramizadeh ◽  
Mohammad Ebrahim Mousavi ◽  
Mehdi Rassafiani ◽  
Gholamreza Aminian ◽  
Ismail Ebrahimi ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Postural Control ◽  
Sagittal Plane ◽  
Standing Position ◽  
Force Platform ◽  
Spastic Cerebral Palsy ◽  
Phase Plate ◽  
Ankle Foot Orthosis ◽  
Objective Evidence ◽  
Foot Orthosis

Background: Children with cerebral palsy (CP) often demonstrate postural control difficulties. Orthotic management may assist in improving postural control in these children.Objective: The purpose of this investigation was to examine the influence of floor reaction ankle foot orthosis (FRAFO) on postural flexion called the crouch position in children with CP.Study Design: Quasi-experimental.Methods: Eight children with spastic diplegic CP and eight matched typically developing children participated in this study. Postural control of children with CP was assessed in a static standing position on a force platform with/without a FRAFO. The parameters used were centre of pressure (CoP) measures, calculated from force platform signals including the standard deviation (SD) of excursion; phase plate portrait and SD of velocity in anteroposterior (AP) and mediolateral (ML) directions.Results: The maximum knee extension was statistically significant in children with CP when barefoot compared to wearing braced footwear ( p < 0.05, t = 10.01). AP and ML displacement, AP velocity and AP phase plate portrait of CoP were not statistically significant between children with CP with/without a FRAFO ( p < 0.05).Conclusion: FRAFO can improve the alignment of the knee, but may not be helpful in improving postural control in children with CP in a short time period.Clinical relevanceThis article will provide objective evidence about the effect of FRAFO on the postural control in children with CP. Therapists can use FRAFO to effectively decrease the knee joint angle in the sagittal plane in children with spastic CP, but cannot use it to improve the postural control.

scholarly journals Combination taping technique versus ankle foot orthosis on improving gait parameters in spastic cerebral palsy: A controlled randomized study

2021 ◽  
Author(s):  
Mohamed A. Abdel Ghafar ◽  
Osama R Abdelraouf ◽  
Amr A. Abdel-aziem ◽  
Gihan Samir Mousa ◽  
Ali O. Selim ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Randomized Study ◽  
Spastic Cerebral Palsy ◽  
Control Group ◽  
Spastic Diplegia ◽  
Post Intervention ◽  
Double Support ◽  
Ankle Foot Orthosis ◽  
Gait Parameters ◽  
Foot Orthosis

Background: One of the important goals in the treatment of spastic cerebral palsy is to maintain efficient and effective walking in order to be independent in activities and participate in society. Objective: To compare the efficacy of foot combination taping of kinesio tape and athletic tape vs ankle foot orthosis in correcting spatiotemporal gait parameters in children with spastic diplegia. Methods: Thirty-six children with spastic diplegia were randomly assigned into 3 groups; control, combination taping, and ankle foot orthosis groups. Children in the control group, in addition to those in both experimental groups, continued with conventional physical therapy, 1 h, 3 times per week for 4 weeks. Spatiotemporal gait parameters were assessed with the GAITRite system before and after the application of interventions. Results: Significant increases in walking velocity, step length, stride length, right single support duration, and left single support duration of the ankle foot orthosis and combination taping groups than pre-intervention values. [AQ9] Moreover, the post--intervention values of the double support duration of the ankle foot orthosis and combination taping groups were significantly lower than pre-intervention values. There were no significant differences between the post-intervention values of the ankle foot orthosis and combination taping groups for all parameters. Conclusion: The results demonstrated that combination taping is an effective alternative technique to ankle foot orthosis to improve spatiotemporal parameters in children with spastic diplegic in combination with conventional physiotherapy.

scholarly journals The role of rigid and hinged polypropylene ankle-foot-orthoses in the management of cerebral palsy: a case study

1988 ◽  
Vol 12 (3) ◽  
pp. 129-135 ◽  
Author(s):  
E. A. Middleton ◽  
G. R. B. Hurley ◽  
J. S. McIlwain
Keyword(s):  
Cerebral Palsy ◽  
Reaction Force ◽  
Force Plate ◽  
Spastic Cerebral Palsy ◽  
Foot Orthoses ◽  
Ankle Motion ◽  
Ankle Foot Orthosis ◽  
Ankle Foot Orthoses ◽  
The Subject ◽  
Foot Orthosis

Ankle-foot orthoses are commonly used in the treatment of spastic cerebral palsy to hold the foot in a position conducive to a more functional gait. This study, utilizing quantitative biomechanical techniques, evaluates the effects of a rigid ankle-foot orthosis and a hinged ankle-foot orthosis on spastic cerebral palsy gait. The subject was a 4.5 year old female diagnosed as spastic diplegic cerebral palsied shortly after birth. Testing involved collection of kinematic coordinate data employing a WATSMART video system and ground reaction force' data using a Kistler force plate. Jensen's (1978) photogrammetric method was used to estimate body segment inertial parameters. The hinged ankle-foot orthosis was found to be more effective than the rigid ankle-foot orthosis. The subject exhibited a more natural ankle motion during the stance phase of gait, greater symmetry of segmental lower extremity motion, and decreased knee moments during stance while wearing a hinged ankle-foot orthosis.

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