Effects of plantar flexion resistive moment generated by an ankle-foot orthosis with an oil damper on the gait of stroke patients: a pilot study

Background: An ankle-foot orthosis with an oil damper was previously developed to assist the first rocker function during gait, but the effects of the amount of resistive moment generated on gait have not been clarified. Objectives: To measure the amount of resistive moment generated by the ankle-foot orthosis with an oil damper during gait and determine its effect on the gait of patients with stroke. Study Design: Preliminary cross-sectional study. Methods: The gait of four patients with stroke in the chronic phase was measured in four conditions: without an ankle-foot orthosis and with the ankle-foot orthosis with an oil damper generating three different amounts of resistive moment. Measurements were taken with a three-dimensional motion analysis system and a specially designed device to determine the resistive moment. Results: The resistive moment was observed in the former half in stance of the paretic limb, and its magnitude was less than 10 N m. Some gait parameters related to terminal stance and preswing were affected by the amount of resistive moment. The forward component of floor reaction force and the shank vertical angle showed peak values when the patients reported feeling most comfortable during gait. Conclusion: Although the resistive moment generated by the ankle-foot orthosis with an oil damper was small, it was sufficient to alter gait. Clinical relevance To maximize the effectiveness of ankle-foot orthoses, it is necessary to know the effects of resistive moment on the gait of patients with stroke. The ankle-foot orthosis with an oil damper assists the first rocker function in gait and also affects the gait in a later phase in stance. The peak values of some gait parameters coincided with patients reporting gait to be most comfortable. It is important to know that ankle-foot orthosis with an oil damper assistance in the first rocker alters the weight acceptance on the paretic limb and affects the gait parameters related to propulsion ability in stance.

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Status of Consultation and Local Collaboration Regarding Ankle-Foot Orthosis in the Life Period: A Cross-sectional Study of Care Managers

Rigakuryoho Kagaku ◽

10.1589/rika.33.941 ◽

2018 ◽

Vol 33 (6) ◽

pp. 941-945

Author(s):

Noriyuki ABE ◽

Takahiro HOSOYA ◽

Tadamitsu MATSUDA

Keyword(s):

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Ankle Foot Orthosis ◽

Care Managers ◽

Life Period ◽

Foot Orthosis

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The Capacity to Restore Steady Gait After a Step Modification Is Reduced in People With Poststroke Foot Drop Using an Ankle-Foot Orthosis

Physical Therapy ◽

10.2522/ptj.20130108 ◽

2014 ◽

Vol 94 (5) ◽

pp. 654-663 ◽

Cited By ~ 9

Author(s):

Roos van Swigchem ◽

Melvyn Roerdink ◽

Vivian Weerdesteyn ◽

Alexander C. Geurts ◽

Andreas Daffertshofer

Keyword(s):

Obstacle Avoidance ◽

Chronic Phase ◽

Step Length ◽

Foot Drop ◽

Control Group ◽

Success Rates ◽

Cross Sectional ◽

Ankle Foot Orthosis ◽

Hip Flexion ◽

Foot Orthosis

BackgroundA reduced capacity to modify gait to the environment may contribute to the risk of falls in people with poststroke foot drop using an ankle-foot orthosis.ObjectiveThis study aimed to quantify their capacity to restore steady gait after a step modification.DesignThis was a cross-sectional, observational study.MethodsNineteen people in the chronic phase (>6 months) after stroke (mean age=55.0 years, SD=10.1) and 20 people of similar age (mean age=54.6 years, SD=12.0) who were able-bodied were included. Participants were instructed to avoid obstacles that were suddenly released in front of the paretic leg (stroke group) or left leg (control group) while walking on a treadmill. Outcomes were success rates of obstacle avoidance as well as post-crossing step length, step duration, hip flexion angle at foot-strike, and peak hip extension of the steps measured within 10 seconds following obstacle release.ResultsSuccess rates of obstacle avoidance were lower for people poststroke. Moreover, their first post-crossing step length and duration (ie, the nonparetic step) deviated more from steady gait than those of people in the control group (ie, the right step), with lower values for people poststroke. Similar deviations were observed for post-crossing hip flexion and extension excursions.LimitationsPeople poststroke were relatively mildly impaired and used an ankle-foot orthosis, which may limit the generalizability of the results to other populations poststroke.ConclusionsPeople with poststroke foot drop using an ankle-foot orthosis had reduced gait adaptability, as evidenced by lower success rates of obstacle avoidance as well as an impaired capacity to restore steady gait after crossing an obstacle. The latter finding unveils their difficulty in incorporating step modifications in ongoing gait.

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Efficacy of a newly designed trunk orthosis with joints providing resistive force in adults with post-stroke hemiparesis

Prosthetics and Orthotics International ◽

10.1177/0309364614545420 ◽

2014 ◽

Vol 40 (1) ◽

pp. 129-136 ◽

Cited By ~ 2

Author(s):

Junji Katsuhira ◽

Nodoka Miura ◽

Tadashi Yasui ◽

Takane Mitomi ◽

Sumiko Yamamoto

Keyword(s):

Plantar Flexion ◽

Three Dimensional ◽

Chronic Phase ◽

Step Length ◽

Gait Training ◽

Kinematic Parameters ◽

Stroke Patients ◽

Experimental Conditions ◽

Resistive Force ◽

Paretic Limb

Background: Few studies have examined the efficacy of trunk orthoses that support the upper trunk and a paretic limb in stroke patients. To improve stability and alignment of the trunk and pelvis in hemiparetic patients, we developed a newly designed trunk orthosis that provides resistive force through spring joints. Objectives: This study aimed to determine the newly designed trunk orthosis’s biomechanical effects during level walking. Study design: Before-after trials must be better. Methods: Measurements were taken for nine chronic-phase (>2 years post-onset) stroke patients using a three-dimensional motion capture system and force plates under three experimental conditions: self-selected gait speed without the newly designed trunk orthosis, with the newly designed trunk orthosis, and after newly designed trunk orthosis removal. We analyzed and compared spatiotemporal and kinetic parameters of the paretic and non-paretic limbs and kinematic parameters of the trunk and bilateral limbs. Results: Several pre-swing gait parameters (e.g. hip joint flexion moment and ankle joint plantar flexion angle) after newly designed trunk orthosis removal were significantly increased compared to those without newly designed trunk orthosis. Step length of the paretic limb tended to increase after newly designed trunk orthosis removal. Conclusion: The newly designed trunk orthosis effectively modified trunk alignment, but larger improvements in kinetic and kinematic parameters were observed in the bilateral limbs after newly designed trunk orthosis removal than with the newly designed trunk orthosis. Clinical relevance Stroke patients improved only trunk malalignment while wearing the newly designed trunk orthosis. Gait after newly designed trunk orthosis removal was better than with the newly designed trunk orthosis. Positive changes after removal were mostly observed in pre-swing of the hemiparetic limb. The newly designed trunk orthosis might be effective for gait training in stroke patients.

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Effect of AFO Design on Walking after Stroke: Impact of Ankle Plantar Flexion Contracture

Prosthetics and Orthotics International ◽

10.3109/03093646.2010.501512 ◽

2010 ◽

Vol 34 (3) ◽

pp. 277-292 ◽

Cited By ~ 58

Author(s):

Sara J. Mulroy ◽

Valerie J. Eberly ◽

Joanne K. Gronely ◽

Walter Weiss ◽

Craig J. Newsam

Keyword(s):

Knee Flexion ◽

Plantar Flexion ◽

Flexion Contracture ◽

Ankle Dorsiflexion ◽

Emg Activity ◽

Ankle Foot Orthosis ◽

Gait Parameters ◽

Ankle Plantar Flexion ◽

Anterior Tibialis ◽

Foot Orthosis

This study was conducted to compare the effects of three ankle-foot orthosis (AFO) designs on walking after stroke and determine whether an ankle plantar flexion contracture impacts response to the AFOs. A total of 30 individuals, ranging from 6–215 months post-stroke, were tested in four conditions: shoes only (SH), dorsi-assist/dorsi-stop AFO (DA-DS), plantar stop/free dorsiflexion AFO (PS), and rigid AFO (Rigid). Kinematics, kinetics, and electromyographic (EMG) activity were recorded from the hemiparetic lower extremity while participants walked at a self-selected pace. Gait parameters were compared between conditions and between participants with and without a moderate ankle plantar flexion contracture. All AFOs increased ankle dorsiflexion in swing and early stance. Anterior tibialis EMG was reduced only in the PS AFO. Both PS and Rigid AFOs restricted ankle plantar flexion and increased knee flexion in loading. Peak ankle dorsiflexion in stance and soleus EMG intensity were greatest in the PS AFO. The Rigid AFO tended to restrict dorsiflexion in stance and knee flexion in swing only in participants without a plantar flexion contracture. Individuals without a contracture benefit from an AFO that permits dorsiflexion mobility in stance and those with quadriceps weakness may more easily tolerate an AFO with plantar flexion mobility in loading.

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Comparison of the quality of life in individuals with spinal cord injury wearing either reciprocating gait orthosis or hip knee ankle foot orthosis: a cross-sectional study

Disability and Rehabilitation Assistive Technology ◽

10.1080/17483107.2019.1685014 ◽

2020 ◽

pp. 1-5

Author(s):

Kourosh Barati ◽

Mojtaba Kamyab ◽

Mohammad Kamali

Keyword(s):

Quality Of Life ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Ankle Foot Orthosis ◽

Cord Injury ◽

Foot Orthosis

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Immediate-term effects of use of an ankle–foot orthosis with an oil damper on the gait of stroke patients when walking without the device

Prosthetics and Orthotics International ◽

10.1177/0309364613518340 ◽

2014 ◽

Vol 39 (2) ◽

pp. 140-149 ◽

Cited By ~ 12

Author(s):

Sumiko Yamamoto ◽

Setsuro Ibayashi ◽

Masako Fuchi ◽

Tadashi Yasui

Keyword(s):

Ankle Joint ◽

Three Dimensional ◽

Chronic Phase ◽

Therapeutic Effects ◽

Stroke Patients ◽

Joint Power ◽

Ankle Foot Orthosis ◽

Natural Movement ◽

Analysis System ◽

Foot Orthosis

Background:An ankle–foot orthosis using an oil damper is designed to enable natural movement of the ankle joint. Wearing an ankle–foot orthosis using an oil damper has been demonstrated to assist the first rocker in stroke patients, but its effect on their gait when not wearing it is unclear.Objectives:To determine the effect of use of ankle–foot orthosis using an oil damper on the gait of stroke patients with hemiparesis when not wearing the ankle–foot orthosis.Study design:Crossover study.Methods:The gait of eight stroke patients in the chronic phase when not wearing an ankle–foot orthosis was measured, using a three-dimensional motion analysis system, before using the ankle–foot orthosis using an oil damper and then without and with using the ankle–foot orthosis using an oil damper after 3 weeks of use. Differences in gait were compared between the three measurement conditions.Results:Use of ankle–foot orthosis using an oil damper significantly decreased preswing time and significantly increased the positive ankle joint power in stance when not wearing the ankle–foot orthosis using an oil damper.Conclusions:These changes indicate the promising therapeutic effects of ankle–foot orthosis using an oil damper use and suggest the ankle–foot orthosis using an oil damper’s potential as a therapeutic device.Clinical relevanceAfter 3 weeks of use of an ankle–foot orthosis using an oil damper, which assists the first rocker, the gait of stroke patients in the chronic phase when not wearing the ankle–foot orthosis using an oil damper was improved. Preswing time was significantly decreased and positive ankle joint power was significantly increased. The ankle–foot orthosis using an oil damper, which assists the first rocker function with natural movement of the ankle joint during gait, has the potential to improve the gait of stroke patients after immediate-term use.

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Comparing the Effects of Functional Electrical Stimulation With and Without Ankle-foot Orthosis on the Balance and Walking Ability of Patients With Multiple Sclerosis

Iranian Rehabilitation Journal ◽

10.32598/irj.19.3.1474.1 ◽

2021 ◽

Vol 19 (3) ◽

pp. 307-314

Author(s):

Parisa Aslani ◽

◽

Alireza Khaghani ◽

Taher Babaee ◽

◽

...

Keyword(s):

Multiple Sclerosis ◽

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Clinical Manifestations ◽

Cross Sectional Study ◽

Walking Ability ◽

Cross Sectional ◽

Ankle Foot Orthosis ◽

Study Results ◽

Foot Orthosis

Objectives: Multiple Sclerosis (MS) is an autoimmune disease of the central nervous system that is the second leading cause of nerve failure in young adults. One of the clinical manifestations of MS is impaired balance and gait. Ankle-foot Orthosis (AFO) and Functional Electrical Stimulation (FES) are the most common rehabilitation interventions to improve the patients’ gait and balance. This study aimed to evaluate and compare the effect of using an FES system and an AFO equipped with FES on the gait and balance of patients with MS. Methods: This research was a cross-sectional study. The patients were included in the study who were diagnosed with MS, had a score of lower than five on the expanded disability status scale, had a history of drop foot for at least three months, aged 20-50 years, and prescribed an AFO or FES, or both. The participants were asked to wear the FES system to evaluate their balance and ability to walk using the Balance Evaluation Systems Test (BESTest). Then, the participants were asked to wear an AFO equipped with FES, and their balance and ability to walk were assessed again. Results: The AFO equipped with FES provides more gait stability than FES alone condition (P <0.05). The ability of patients to use the FES alone was greater than using the AFO equipped with FES (P<0.05). Discussion: The study results showed that the walking ability of MS patients using an FES system is greater than that of AFO equipped with FES. This outcome can be due to the difficulty and limiting effect of using an orthosis on their performance. However, the patient’s postural response during stepping back and forth in the condition of AFO equipped with the FES system was better than the FES system alone.

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