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 a knee ankle foot orthosis incorporating an active knee mechanism on gait of a person with poliomyelitis

2013 ◽  
Vol 37 (5) ◽  
pp. 411-414 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Ahmad Chitsazan ◽  
Monireh Ahmadi Bani ◽  
Gholamreza Rouhi ◽  
Farhad Tabatabai Ghomshe ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Walking Speed ◽  
Horizontal Displacement ◽  
Step Length ◽  
Knee Extension ◽  
Knee Joints ◽  
Ankle Foot Orthosis ◽  
Stance Control ◽  
Control Knee ◽  
Foot Orthosis

Background: The aim of this case study was to identify the effect of a powered stance control knee ankle foot orthosis on the kinematics and temporospatial parameters of walking by a person with poliomyelitis when compared to a knee ankle foot orthosis. Case description and methods: A knee ankle foot orthosis was initially manufactured by incorporating drop lock knee joints and custom molded ankle foot orthoses and fitted to a person with poliomyelitis. The orthosis was then adapted by adding electrically activated powered knee joints to provide knee extension torque during stance and also flexion torque in swing phase. Lower limb kinematic and kinetic data plus data for temporospatial parameters were acquired from three test walks using each orthosis. Findings and outcomes: Walking speed, step length, and vertical and horizontal displacement of the pelvis decreased when walking with the powered stance control knee ankle foot orthosis compared to the knee ankle foot orthosis. When using the powered stance control knee ankle foot orthosis, the knee flexion achieved during swing and also the overall pattern of walking more closely matched that of normal human walking. The reduced walking speed may have caused the smaller compensatory motions detected when the powered stance control knee ankle foot orthosis was used. Conclusion: The new powered SCKAFO facilitated controlled knee flexion and extension during ambulation for a volunteer poliomyelitis person. Clinical relevance The powered stance control knee ankle foot orthosis has the potential to improve knee joint kinematics in persons with poliomyelitis when ambulating.

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.

The influence of a powered knee–ankle–foot orthosis on walking in poliomyelitis subjects: A pilot study

2015 ◽  
Vol 40 (3) ◽  
pp. 377-383 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Alireza Moradi ◽  
Mohammad Samadian ◽  
Mahmood Bahramizadeh ◽  
Mahmoud Joghtaei ◽  
...  
Keyword(s):  
Knee Joint ◽  
Knee Flexion ◽  
Stance Phase ◽  
Step Length ◽  
Gait Pattern ◽  
Swing Phase ◽  
Ankle Foot Orthosis ◽  
Active Flexion ◽  
Locked Knee ◽  
Foot Orthosis

Background:Traditionally, the anatomical knee joint is locked in extension when walking with a conventional knee–ankle–foot orthosis. 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 differences of the powered knee–ankle–foot orthosis compared to a locked knee–ankle–foot orthosis in kinematic data and temporospatial parameters during ambulation.Study design:Quasi—experimental design.Methods:Subjects with poliomyelitis (n = 7) volunteered for this study and undertook gait analysis with both the powered and the conventional knee–ankle–foot orthoses. Three trials per orthosis were collected while each subject walked along a 6-m walkway using a calibrated six-camera three-dimensional video-based motion analysis system.Results:Walking with the powered knee–ankle–foot orthosis resulted in a significant reduction in both walking speed and step length (both 18%), but a significant increase in stance phase percentage compared to walking with the conventional knee–ankle–foot orthosis. Cadence was not significantly different between the two test conditions ( p = 0.751). There was significantly higher knee flexion during swing phase and increased hip hiking when using the powered orthosis.Conclusion:The new powered orthosis permitted improved knee joint kinematic for knee–ankle–foot orthosis users while providing knee support in stance and active knee motion in swing in the gait cycle. Therefore, the new powered orthosis provided more natural knee flexion during swing for orthosis users compared to the locked knee–ankle–foot orthosis.Clinical relevanceThis orthosis has the potential to improve knee joint kinematics and gait pattern in poliomyelitis subjects during walking activities.

The gait and energy efficiency of stance control knee–ankle–foot orthoses: A literature review

2015 ◽  
Vol 40 (2) ◽  
pp. 202-214 ◽  
Author(s):  
Masoud Rafiaei ◽  
Mahmood Bahramizadeh ◽  
Mokhtar Arazpour ◽  
Mohammad Samadian ◽  
Stephen W Hutchins ◽  
...  
Keyword(s):  
Muscle Weakness ◽  
Quadriceps Muscle ◽  
Knee Joints ◽  
Foot Orthoses ◽  
Ankle Foot Orthosis ◽  
Gait Kinematics ◽  
Stance Control ◽  
Ankle Foot Orthoses ◽  
Locked Knee ◽  
Foot Orthosis

Background: The use of knee–ankle–foot orthoses with drop locked knee joints produces some limitations for walking in subjects with quadriceps muscle weakness. The development of stance control orthoses can potentially improve their functionality. Objectives: The aim of this review was to compare the evidence of the effect of stance control orthoses to knee–ankle–foot orthoses with drop locked knee joints in improving kinematic variables and energy efficiency of walking by subjects with quadriceps muscle weakness caused by different pathologies. Study design: Literature review. Methods: Based on selected keywords and their composition, a search was performed in Google Scholar, PubMed, ScienceDirect, and ISI Web of Knowledge databases. In total, 18 articles were finally chosen for review. Results: The results of this study demonstrated that this type of orthosis can improve the walking parameters of subjects with quadriceps muscle weakness and spinal cord injury patients when compared to a locked knee–ankle–foot orthosis. Conclusion: There is evidence to show that stance control orthosis designs improve the gait kinematics but not energetic of knee–ankle–foot orthosis users. Development of new designs of stance control orthoses to provide a more normal pattern of walking is still required. Clinical relevance Stance control orthoses are a new generation of orthotic intervention that could potentially be significant in assisting to improve the gait kinematics by knee–ankle–foot orthosis users.

scholarly journals Pengaruh Penggunaan Ankle Foot Orthosis Dinamis Terhadap Kecepatan Jalan Pada Anak Penderita Cerebral Palsy

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Cica Trimandasari M ◽  
Sri Surini Pudjiastuti
Keyword(s):  
Cerebral Palsy ◽  
Walking Speed ◽  
Wilcoxon Test ◽  
Spastic Cerebral Palsy ◽  
Motor Disorder ◽  
Ankle Foot Orthosis ◽  
Children With Cerebral Palsy ◽  
Before And After ◽  
Quasi Experimental ◽  
Foot Orthosis

Background: cerebral palsy is a non-progressive motor disorder that causes limited activity, paralysis, inability to control motion and is often accompanied by cognitive impairment or visual deficits.Children who experience cerebral palsy will definitely have limitations in the process of mobility. To help limitation of activity that occurs in children with cerebral palsy, ankle foot orthosis is used. Ankle foot orthosis is expected to help the patient in performing his activities at all times to give effect on the walking speed. In this research, actions performed by taking data before and after using dynamic ankle foot orthosis. Purpose of this research to determine the effect of the use of dynamic ankle foot orthosis on walking speed ​​in children with cerebral palsy ". Methods: This type of research is quasi experimental pre and post test design. The subjects used were spastic cerebral palsy spherical patients in the Pediatric & Neurodevelopmental Therapy Center (PNTC) who had determined the inclusion and exclusion criteria. Number of subjects 15 people. Result: This research is based on data analysis result that wilcoxon test value got p = 0,001 (p <0,05). Conclusion: This result indicates that there is an effect of the use of ankle foot orthosis dynamic on road speed in children with cerebral palsy.

scholarly journals Effectiveness of an ankle–foot orthosis on walking in patients with stroke: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoo Jin Choo ◽  
Min Cheol Chang
Keyword(s):  
Stride Length ◽  
Walking Speed ◽  
Sagittal Plane ◽  
Meta Analysis ◽  
Step Length ◽  
Stride Time ◽  
Plane Angle ◽  
Ankle Foot Orthosis ◽  
Biomechanical Parameters ◽  
Foot Orthosis

AbstractWe conducted a meta-analysis to investigate the effectiveness of ankle–foot orthosis (AFO) use in improving gait biomechanical parameters such as walking speed, mobility, and kinematics in patients with stroke with gait disturbance. We searched the MEDLINE (Medical Literature Analysis and Retrieval System Online), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, Embase, and Scopus databases and retrieved studies published until June 2021. Experimental and prospective studies were included that evaluated biomechanics or kinematic parameters with or without AFO in patients with stroke. We analyzed gait biomechanical parameters, including walking speed, mobility, balance, and kinematic variables, in studies involving patients with and without AFO use. The criteria of the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate the methodological quality of the studies, and the level of evidence was evaluated using the Research Pyramid model. Funnel plot analysis and Egger’s test were performed to confirm publication bias. A total of 19 studies including 434 participants that reported on the immediate or short-term effectiveness of AFO use were included in the analysis. Significant improvements in walking speed (standardized mean difference [SMD], 0.50; 95% CI 0.34–0.66; P < 0.00001; I2, 0%), cadence (SMD, 0.42; 95% CI 0.22–0.62; P < 0.0001; I2, 0%), step length (SMD, 0.41; 95% CI 0.18–0.63; P = 0.0003; I2, 2%), stride length (SMD, 0.43; 95% CI 0.15–0.71; P = 0.003; I2, 7%), Timed up-and-go test (SMD, − 0.30; 95% CI − 0.54 to − 0.07; P = 0.01; I2, 0%), functional ambulation category (FAC) score (SMD, 1.61; 95% CI 1.19–2.02; P < 0.00001; I2, 0%), ankle sagittal plane angle at initial contact (SMD, 0.66; 95% CI 0.34–0.98; P < 0.0001; I2, 0%), and knee sagittal plane angle at toe-off (SMD, 0.39; 95% CI 0.04–0.73; P = 0.03; I2, 46%) were observed when the patients wore AFOs. Stride time, body sway, and hip sagittal plane angle at toe-off were not significantly improved (p = 0.74, p = 0.07, p = 0.07, respectively). Among these results, the FAC score showed the most significant improvement, and stride time showed the lowest improvement. AFO improves walking speed, cadence, step length, and stride length, particularly in patients with stroke. AFO is considered beneficial in enhancing gait stability and ambulatory ability.

Classifications of Intentions for Controlling of a Multifunctional Knee-Ankle-Foot Orthosis

2011 ◽  
Author(s):  
Sai-Kit Wu ◽  
Tad Driver ◽  
Xiangrong Shen
Keyword(s):  
Walking Speed ◽  
Accuracy Rate ◽  
Bayes Method ◽  
Ankle Foot Orthosis ◽  
Significant Step ◽  
Reaction Forces ◽  
Velocity Information ◽  
Foot Orthosis ◽  
Motion Intention

This paper describes motion intention classifiers which utilize reaction forces signals from heel and toe; and hip velocity information to predict subject’s intention. Those classifiers using Bayes method to predict (i) walk-to-stop, (ii) walking-speed-changing, and (iii) stop-to-motions. They are very accurate (most of them have accuracy rate higher than 90%) and a significant step in order to develop a multifunctional knee-ankle-foot orthosis.

scholarly journals Control Reference Parameter for Stance Assistance Using a Passive Controlled Ankle Foot Orthosis—A Preliminary Study

2019 ◽  
Vol 9 (20) ◽  
pp. 4416 ◽  
Author(s):  
Dimas Adiputra ◽  
Mohd Azizi Abdul Rahman ◽  
Ubaidillah ◽  
Saiful Amri Mazlan ◽  
Nurhazimah Nazmi ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Standard Error ◽  
Walking Speed ◽  
Parameters Estimation ◽  
Ankle Foot Orthosis ◽  
Preliminary Study ◽  
Reference Parameters ◽  
Walking Speeds ◽  
Foot Orthosis

This paper aims to present a preliminary study of control reference parameters for stance assistance among different subjects and walking speeds using a passive-controlled ankle foot orthosis. Four young male able-bodied subjects with varying body mass indexes (23.842 ± 4.827) walked in three walking speeds of 1, 3, and 5 km/h. Two control references, average ankle torque (aMa), and ankle angular velocity (aω), which can be implemented using a magnetorheological brake, were measured. Regression analysis was conducted to identify suitable control references in the three different phases of the stance. The results showed that aω has greater correlation (p) with body mass index and walking speed compared to aMa in the whole stance phase (p1(aω) = 0.666 > p1(aMa) = 0.560, p2(aω) = 0.837 > p2(aMa) = 0.277, and p3(aω) = 0.839 > p3(aMa) = 0.369). The estimation standard error (Se) of the aMa was found to be generally higher than of aω (Se1(aMa) = 2.251 > Se1(aω) = 0.786, Se2(aMa) = 1.236 > Se2(aω) = 0.231, Se3(aMa) = 0.696 < Se3(aω) = 0.755). Future studies should perform aω estimation based on body mass index and walking speed, as suggested by the higher correlation and lower standard error as compared to aMa. The number of subjects and walking speed scenarios should also be increased to reduce the standard error of control reference parameters estimation.

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