scholarly journals Ambulatory Function and Perception of Confidence in Persons with Stroke with a Custom-Made Hinged versus a Standard Ankle Foot Orthosis

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Angélique Slijper ◽  
Anna Danielsson ◽  
Carin Willén
Keyword(s):  
Carbon Composite ◽  
Stair Climbing ◽  
Walking Distance ◽  
Cost Index ◽  
Ankle Foot Orthosis ◽  
Physiological Cost ◽  
Custom Made ◽  
Test Velocity ◽  
Mean Differences ◽  
Foot Orthosis

Objective. The aim was to compare walking with an individually designed dynamic hinged ankle foot orthosis (DAFO) and a standard carbon composite ankle foot orthosis (C-AFO).Methods. Twelve participants, mean age 56 years (range 26–72), with hemiparesis due to stroke were included in the study. During the six-minute walk test (6MW), walking velocity, the Physiological Cost Index (PCI), and the degree of experienced exertion were measured with a DAFO and C-AFO, respectively, followed by a Stairs Test velocity and perceived confidence was rated.Results. The mean differences in favor for the DAFO were in 6MW 24.3 m (95% confidence interval [CI] 4.90, 43.76), PCI −0.09 beats/m (95% CI −0.27, 0.95), velocity 0.04 m/s (95% CI −0.01, 0.097), and in the Stairs Test −11.8 s (95% CI −19.05, −4.48). All participants except one perceived the degree of experienced exertion lower and felt more confident when walking with the DAFO.Conclusions. Wearing a DAFO resulted in longer walking distance and faster stair climbing compared to walking with a C-AFO. Eleven of twelve participants felt more confident with the DAFO, which may be more important than speed and distance and the most important reason for prescribing an AFO.

scholarly journals The physiological cost index of walking with a powered knee–ankle–foot orthosis in subjects with poliomyelitis: A pilot study

2015 ◽  
Vol 40 (4) ◽  
pp. 454-459 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Monireh Ahmadi Bani ◽  
Mohammad Samadian ◽  
Mohammad E Mousavi ◽  
Stephen W Hutchins ◽  
...  
Keyword(s):  
Walking Speed ◽  
Knee Joints ◽  
Cost Index ◽  
Ankle Foot Orthosis ◽  
Physiological Cost ◽  
Active Flexion ◽  
Quasi Experimental ◽  
Locked Knee ◽  
Foot Orthosis ◽  
Flexion And Extension

Background: A powered knee–ankle–foot orthosis was developed to provide restriction of knee flexion during stance phase and active flexion and extension of the knee during swing phase of gait. Objective: The purpose of this study was to determine its effect on the physiological cost index, walking speed and the distance walked in people with poliomyelitis compared to when walking with a knee–ankle–foot orthosis with drop lock knee joints. Study design: Quasi experimental study. Methods: Seven subjects with poliomyelitis volunteered for the study and undertook gait analysis with both types of knee–ankle–foot orthosis. Results: Walking with the powered knee–ankle–foot orthosis significantly reduced walking speed ( p = 0.015) and the distance walked ( p = 0.004), and also, it did not improve physiological cost index values ( p = 0.009) compared to walking with the locked knee–ankle–foot orthosis. Conclusion: Using a powered knee–ankle–foot orthosis did not significantly improve any of the primary outcome measures during walking for poliomyelitis subjects. Clinical relevance This powered knee–ankle–foot orthosis design did not improve the physiological cost index of walking for people with poliomyelitis when compared to walking with a knee–ankle–foot orthosis with drop lock knee joints. This may have been due to the short training period used or the bulky design and additional weight of the powered orthosis. Further research is therefore warranted.

The effect of trunk extension on physiological cost index in spinal cord injury patients when using the advanced reciprocating gait orthosis: A pilot study

2016 ◽  
Vol 40 (6) ◽  
pp. 696-702 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Mohammad Samadian ◽  
Mahmood Bahramizadeh ◽  
Monireh Ahmadi Bani ◽  
Masoud Gharib ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Walking Speed ◽  
Well Being ◽  
Walking Distance ◽  
Cost Index ◽  
Physiological Cost ◽  
Cord Injury ◽  
Trunk Extension

Background:People with spinal cord injury walk with a flexed trunk when using reciprocating gait orthoses for walking. Reduction in trunk flexion during ambulation has been shown to improve gait parameters for reciprocating gait orthosis users.Objective:The aim of this study was to investigate the effect on energy expenditure when spinal cord injury patients ambulate with an advanced reciprocating gait orthosis while wearing a thoracolumbosacral orthosis to provide trunk extension.Study design:Quasi experimental study.Methods:Four patients with spinal cord injury were fitted with an advanced reciprocating gait orthosis after completing a specific gait training program. Patients walked along a flat walkway using the advanced reciprocating gait orthosis as a control condition and also while additionally wearing a thoracolumbosacral orthosis at their self-selected walking speed. A stopwatch and a polar heart rate monitor were used to measure walking speed and heart rate.Results:Walking speed, the distance walked, and the physiological cost index all improved when walking with the advanced reciprocating gait orthosis/thoracolumbosacral orthosis test condition compared to walking with no thoracolumbosacral orthosis in situ.Conclusion:Spinal cord injury patients can improve their walking speed, walking distance, and physiological cost index when wearing a thoracolumbosacral orthosis in conjunction with an advanced reciprocating gait orthosis, which may be attributed to the trunk extension provided by the thoracolumbosacral orthosis.Clinical relevanceIt is concluded that wearing thoracolumbosacral orthosis in association with an advanced reciprocating gait orthosis could be an effective alternative in rehabilitation for thoracic level of paraplegic patients to promote their health and well-being.

Design of a segmented custom ankle foot orthosis with custom-made metal strut and 3D-printed footplate and calf shell

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Miguel A. Funes-Lora ◽  
Ryan Posh ◽  
Jeffrey Wensman ◽  
Albert J. Shih
Keyword(s):  
Ankle Foot Orthosis ◽  
Custom Made ◽  
3D Printed ◽  
Foot Orthosis

Adult-Onset Primary Focal Foot Dystonia Improved with Custom Made Ankle-Foot Orthosis

Clinical Pain ◽  
2020 ◽  
Vol 19 (1) ◽  
pp. 40-44
Author(s):  
Seunghwan Lee ◽  
Yong Min Lee ◽  
Kyeong Eun Uhm ◽  
Jongmin Lee
Keyword(s):  
Adult Onset ◽  
Ankle Foot Orthosis ◽  
Custom Made ◽  
Foot Orthosis

scholarly journals Shoe Adaptation after Amputation of the II – V Phalangeal Bones of the Foot

2006 ◽  
Vol 30 (3) ◽  
pp. 324-329
Author(s):  
G. M. Rommers ◽  
H. J. M. Diepstraten ◽  
E. Bakker ◽  
E. Lindeman
Keyword(s):  
Case Reports ◽  
Spring Steel ◽  
Industrial Safety ◽  
Stair Climbing ◽  
Custom Made ◽  
Crush Injuries ◽  
Phalangeal Bone ◽  
Foot Orthosis ◽  
Made In

In The Netherlands, about 50% of all amputations of the lower limb are toes and forefoot amputations. Traumata of toes and mid-foot are rare. Preservation of the foot is the primary goal for treatment. Crush injuries of the foot may be associated with prolonged morbidity. This case study presents an insole solution for the solitary first phalangeal bone after amputation of the phalangeal bones II – V. The normal adaptation for forefoot amputations is stiffening of the sole of the shoe and a rocker bar to improve the toe off phase with load reduction of the forefoot. Because the patient had to do excessive stair climbing during work another solution was chosen. As a foot orthosis, a metal soleplate was made in order to have free movement during loading and toe-off during walking. The soleplate gives safety and provides self-adjusting properties after toe off. This enables the shoe technician to make a shoe without a rocker bar or an extra stiff insole. The 0.5 mm custom-made spring-steel plate is also used as a protective in industrial safety shoes. To improve shoe adaptation more research and case reports have to be published in order to inform doctors and shoe technicians about everyday solutions to partial foot amputations.

COMPUTER AIDED DESIGN AND FABRICATION OF A CUSTOM ARTICULATED ANKLE FOOT ORTHOSIS

2015 ◽  
Vol 15 (04) ◽  
pp. 1550058 ◽  
Author(s):  
MORSHED ALAM ◽  
IMTIAZ AHMED CHOUDHURY ◽  
AZUDDIN BIN MAMAT ◽  
SAJJAD HUSSAIN
Keyword(s):  
Computer Aided Design ◽  
Integrated Design ◽  
Cnc Machining ◽  
Design Approach ◽  
Ankle Foot Orthosis ◽  
Custom Made ◽  
External Model ◽  
Computer Aided ◽  
Aided Design ◽  
Foot Orthosis

Traditional design and manufacturing methods of ankle foot orthosis (AFO) involve manual techniques e.g., casting and molding of the limbs and often depend on trial and error. Three-dimensional scanning allows computer aided design (CAD) tools to be incorporated, however, both approaches rely on the external model of the limb. To design AFO with articulated joint, precise alignment of mechanical and anatomical joint axes is imperative. It is difficult to infer joint axis from external model as it is partially specified by the skeletal structure. In this article, a computer integrated design approach of an articulated AFO has been demonstrated. CAD model of the AFO was developed for a healthy subject's left leg based on the 3D models of skeleton and soft tissue of the limb. Components of the AFO were fabricated by rapid prototyping and CNC machining. The design approach is faster than the traditional techniques and also facilitates exact positioning of articulated ankle joint. The gait analysis indicates that the subject's ankle had to overcome lesser resistance with the custom made AFO compared to a pre-fabricated AFO. Simultaneous viewing of exterior and skeletal geometry might help the clinicians modify the design to enhance performance of the orthotic.

Effect of early compensation of distal motor deficiency by the Chignon ankle-foot orthosis on gait in hemiplegic patients: a randomized pilot study

2011 ◽  
Vol 25 (11) ◽  
pp. 989-998 ◽  
Author(s):  
Mathieu-Panchoa de Sèze ◽  
Clément Bonhomme ◽  
Jean-Christophe Daviet ◽  
Emmanuel Burguete ◽  
Hugues Machat ◽  
...  
Keyword(s):  
Plantar Flexion ◽  
Randomized Study ◽  
Control Group ◽  
Exclusion Criteria ◽  
Ankle Foot Orthosis ◽  
Recovery Processes ◽  
Custom Made ◽  
Motor Deficiency ◽  
Kinematic Assessment ◽  
Foot Orthosis

Objective: To compare the effect of the Chignon ankle-foot orthosis on gait versus a standard ankle-foot orthosis. Method: A multicentre randomized study was conducted in seven rehabilitation centres. Hemiplegic patients were recruited after unilateral stroke lasting less than six months. Exclusion criteria were: impossibility to stand for 10 seconds; ankle passive dorsiflexion <5 degrees with knee flexed to 90 degrees; triceps spasticity ≥3/4 on the Ashworth modified scale; diseases that might impair active participation in the study. Thirteen patients were randomized to the Chignon group and 15 to the control group. Included patients were given a standard ankle-foot orthosis or Chignon ankle-foot orthosis. The Chignon ankle-foot orthosis is an articulated double-stopped custom-made orthosis with elements to assist dorsiflexion and plantar flexion. Gait speed improvement (ten-metre test), kinematic assessment, and functional scales were assessed. Results: Gain ratio of walking speed with the orthosis increased significantly more in the Chignon group than in the control group at day 0 (27.2  ±  36% versus −0.8  ±  17%; P = 0.006), day 30 (39.9  ±  19% versus 7.5  ±  17%; P = 0.0004) and day 90 (44.6  ±  27% versus 17.1  ±  0.3%; P = 0.04). There was also a significant improvement in kinematic parameters and spasticity in the Chignon group. Conclusion: Early compensation of distal motor deficiency by the Chignon ankle-foot orthosis improves the immediate gait of hemiplegics more than the standard ankle-foot orthosis and seems to modify motor recovery processes in the legs after stroke.

scholarly journals The immediate effects of fitting and tuning solid ankle–foot orthoses in early stroke rehabilitation

2014 ◽  
Vol 39 (6) ◽  
pp. 454-462 ◽  
Author(s):  
Bruce Carse ◽  
Roy Bowers ◽  
Barry C Meadows ◽  
Philip Rowe
Keyword(s):  
Stroke Rehabilitation ◽  
Step Length ◽  
Foot Orthoses ◽  
Post Intervention ◽  
Kinematic Effect ◽  
Ankle Foot Orthosis ◽  
Custom Made ◽  
Ankle Foot Orthoses ◽  
Foot Orthosis ◽  
Early Stroke

Background: Ankle-foot orthoses are known to have a generally positive effect on gait in stroke, however the specifc type of AFO and the time point at which it is provided are highly variable in the currently available literature. Objective: The objective was to determine the immediate spatiotemporal and kinematic effect of custom-made solid ankle–foot orthoses in early stroke rehabilitation, compared to shod walking. Methods: Five male and three female participants were recruited to the study ( n = 8), with a mean age of 57 (16) years who were 3.5 (3) weeks post-stroke. Each received a custom-made solid ankle–foot orthosis to a predefined set of design criteria and tuned using heel wedges to control the shank inclination angle during shod walking. Repeated spatiotemporal and three-dimensional gait measures were taken pre- and immediately post-intervention. Study design: A pre–post-test experimental study. Results: With the solid ankle–foot orthosis, walking velocity increased from 0.22 (0.2) to 0.36 (0.3) m/s ( p < 0.05), overall average step length increased from 0.28 (0.1) to 0.37 (0.1) m ( p < 0.05), cadence increased from 45 (19) to 56 (19) steps/min ( p < 0.05) and step length symmetry ratio increased from 0.65 (0.2) to 0.74 (0.2) (not significant). No clear changes were observed in the joint kinematics of the hip and knee. Conclusion: In our small group of early stroke patients who were fitted with a solid ankle–foot orthosis, immediate significant improvements occurred in walking speed, step length and cadence, when compared to walking with shoes only. Clinical relevance This study provides evidence about the immediate effects of custom solid ankle–foot orthoses on gait of early stroke survivors. Ankle–foot orthosis design specifications are fully described for replication. This study suggests that observing global segment orientation may be more useful than joint angles when fitting and tuning ankle–foot orthoses for optimal ankle–foot orthosis/footwear alignment.

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