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

2014 ◽  
Vol 39 (2) ◽  
pp. 140-149 ◽  
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.

scholarly journals Change of rocker function in the gait of stroke patients using an ankle foot orthosis with an oil damper: immediate changes and the short-term effects

2011 ◽  
Vol 35 (4) ◽  
pp. 350-359 ◽  
Author(s):  
Sumiko Yamamoto ◽  
Masako Fuchi ◽  
Tadashi Yasui
Keyword(s):  
Ankle Joint ◽  
Walking Speed ◽  
Chronic Phase ◽  
Gait Training ◽  
Stroke Patients ◽  
Short Term ◽  
Ankle Foot Orthosis ◽  
Spatiotemporal Parameters ◽  
Foot Orthosis ◽  
Short Term Effects

Background: An ankle foot orthosis (AFO) using an oil damper (AFO-OD) to assist the first rocker during gait was previously developed but the effect on the other rocker functions has not been clarified. Objectives: The immediate and short-term effects on the gait of stroke patients with the AFO-OD were investigated from the viewpoint of the rocker function. Study Design: Crossover study. Methods: The gait of eight stroke patients in chronic phase without an AFO, with the AFO-OD, and the gait with AFO-OD after three weeks of continuous use and gait training were measured by 3D motion analysis. Results: Immediate changes observed on use of the AFO-OD were improvements in walking speed, the spatiotemporal parameters, and the angular change of dorsiflexion of the ankle joint. Three weeks of continuous AFO-OD use and gait training showed further improvements in walking speed and the spatiotemporal parameters as well as an increase in dorsiflexion angle and plantar flexor moment of the ankle joint of the paretic limb in stance. Conclusions: These changes produced improvement of the second rocker function, but improvement of the third rocker was insufficient. Results show the importance of gait training to take full advantage of an AFO.

scholarly journals 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

2012 ◽  
Vol 37 (3) ◽  
pp. 212-221 ◽  
Author(s):  
Sumiko Yamamoto ◽  
Naoki Tomokiyo ◽  
Tadashi Yasui ◽  
Toshikazu Kawaguchi
Keyword(s):  
Plantar Flexion ◽  
Reaction Force ◽  
Three Dimensional ◽  
Chronic Phase ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Ankle Foot Orthosis ◽  
Paretic Limb ◽  
Gait Parameters ◽  
Foot Orthosis

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.

Manuscript title: The effect of three dimensional printing hinged ankle foot orthosis in chronic stroke patients

2021 ◽  
Author(s):  
Jimmy Chun-Ming Fu ◽  
Cyuan-Fong Li ◽  
Yu-Hsuan Hsiao ◽  
Feng-Zu Sheen ◽  
Yi-Jen Chen ◽  
...  
Keyword(s):  
Plantar Pressure ◽  
Three Dimensional ◽  
Chronic Stroke ◽  
Stroke Patients ◽  
Three Dimensional Printing ◽  
Ankle Foot Orthosis ◽  
Asymmetry Analysis ◽  
Gait Asymmetry ◽  
Dimensional Printing ◽  
Foot Orthosis

Abstract BackgroundThree-dimensional printing (3DP) is a promising technique utilized in orthosis fabrication, including ankle foot orthosis for stroke patients. However, the effects on ankle biomechanics remains unclear. ObjectivesTo compare the plantar pressure distribution and patient’s subjective experience in chronic stroke patients during 3DP hinged ankle foot orthosis (3DP-HAFO) and anterior ankle foot orthosis (A-AFO) walking MethodsTen patients with first-ever unilateral stroke were enrolled in this study. All patients performed 10-meter walk test in 3 different conditions, including 3DP-HAFO walking, A-AFO walking, and bare foot walking. The plantar pressure parameters including contact area, maximum force, and peak pressure were collected using Pedar X insole system. Gait asymmetry analysis of the plantar pressure parameters was conducted. Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) was used for patient’s satisfaction.Results3DP-HAFO walking revealed significant increase in medial midfoot peak pressure compared to bare foot walking. Gait asymmetry analysis illustrated more even medial midfoot contact area during 3DP-HAFO walking compared to bare foot walking while A-AFO walking did not. In QUEST survey, 3DP-HAFO outweighs A-AFO in fitting and durableness. Conclusions3DP-HAFO may improve ankle instability and gait asymmetry in chronic stroke patients.

scholarly journals Development of an Active Ankle Foot Orthosis to Prevent Foot Drop and Toe Drag in Hemiplegic Patients: A Preliminary Study

2011 ◽  
Vol 8 (3-4) ◽  
pp. 377-384 ◽  
Author(s):  
Jungyoon Kim ◽  
Sungjae Hwang ◽  
Ryanghee Sohn ◽  
Younghee Lee ◽  
Youngho Kim
Keyword(s):  
Ankle Joint ◽  
Three Dimensional ◽  
Swing Phase ◽  
Foot Drop ◽  
Initial Contact ◽  
Ankle Foot Orthosis ◽  
Series Elastic Actuator ◽  
Spatial Parameters ◽  
Preliminary Study ◽  
Foot Orthosis

We developed an active ankle-foot orthosis (AAFO) that controls dorsiflexion/plantarflexion of the ankle joint to prevent foot drop and toe drag during hemiplegic walking. To prevent foot slap after initial contact, the ankle joint must remain active to minimize forefoot collision against the ground. During late stance, the ankle joint must also remain active to provide toe clearance and to aid with push-off. We implemented a series elastic actuator in our AAFO to induce ankle dorsiflexion/plantarflexion. The activator was controlled by signals from force sensing register (FSR) sensors that detected gait events. Three dimensional gait analyses were performed for three hemiplegic patients under three different gait conditions: gait without AFO (NAFO), gait with a conventional hinged AFO that did not control the ankle joint (HAFO), and gait with the newly-developed AFO (AAFO). Our results demonstrate that our newly-developed AAFO not only prevents foot drop by inducing plantarflexion during loading response, but also prevents toe drag by facilitating plantarflexion during pre-swing and dorsiflexion during swing phase, leading to improvement in most temporal-spatial parameters. However, only three hemiplegic patients were included in this gait analysis. Studies including more subjects will be required to evaluate the functionality of our newly developed AAFO.

A three-dimensional model to assess the effect of ankle joint axis misalignments in ankle–foot orthoses

2014 ◽  
Vol 40 (2) ◽  
pp. 240-246 ◽  
Author(s):  
Stefania Fatone ◽  
William Brett Johnson ◽  
Kerice Tucker
Keyword(s):  
Ankle Joint ◽  
Three Dimensional ◽  
Foot Orthoses ◽  
Two Dimensional ◽  
Dimensional Model ◽  
Three Dimensional Model ◽  
Ankle Foot Orthosis ◽  
Joint Axis ◽  
Ankle Foot Orthoses ◽  
Foot Orthosis

Background: Misalignment of an articulated ankle–foot orthosis joint axis with the anatomic joint axis may lead to discomfort, alterations in gait, and tissue damage. Theoretical, two-dimensional models describe the consequences of misalignments, but cannot capture the three-dimensional behavior of ankle–foot orthosis use. Objectives: The purpose of this project was to develop a model to describe the effects of ankle–foot orthosis ankle joint misalignment in three dimensions. Study design: Computational simulation. Methods: Three-dimensional scans of a leg and ankle–foot orthosis were incorporated into a link segment model where the ankle–foot orthosis joint axis could be misaligned with the anatomic ankle joint axis. The leg/ankle–foot orthosis interface was modeled as a network of nodes connected by springs to estimate interface pressure. Motion between the leg and ankle–foot orthosis was calculated as the ankle joint moved through a gait cycle. Results: While the three-dimensional model corroborated predictions of the previously published two-dimensional model that misalignments in the anterior -posterior direction would result in greater relative motion compared to misalignments in the proximal -distal direction, it provided greater insight showing that misalignments have asymmetrical effects. Conclusions: The three-dimensional model has been incorporated into a freely available computer program to assist others in understanding the consequences of joint misalignments. Clinical relevance Models and simulations can be used to gain insight into functioning of systems of interest. We have developed a three-dimensional model to assess the effect of ankle joint axis misalignments in ankle–foot orthoses. The model has been incorporated into a freely available computer program to assist understanding of trainees and others interested in orthotics.

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