Effect of ankle-foot orthosis on level walking in healthy subjects

2019 ◽  
Vol 233 (12) ◽  
pp. 1262-1268
Author(s):  
Mizuki Kato ◽  
Arinori Kamono ◽  
Naomichi Ogihara
Keyword(s):  
Ground Reaction Force ◽  
Healthy Subjects ◽  
Sagittal Plane ◽  
Reaction Force ◽  
Walking Ability ◽  
Vertical Ground Reaction Force ◽  
Walking Gait ◽  
Ankle Foot Orthosis ◽  
Heel Contact ◽  
Foot Orthosis

An ankle-foot orthosis is often prescribed in the rehabilitation of patients with neurological motor disorders such as hemiparesis. However, walking with a unilateral ankle-foot orthosis may not be effectively achieved just by trying to reproduce normal intact walking with a symmetrical gait pattern. Understanding skills to facilitate walking gait with a unilateral ankle-foot orthosis has implications for better rehabilitative interventions to help restore walking ability in patients with stroke. We, therefore, analyzed the kinematics and ground reaction forces of walking with and without an ankle-foot orthosis in healthy subjects to infer the possible skills to facilitate walking gait with a unilateral ankle-foot orthosis. Adult male participants were asked to walk with and without an ankle-foot orthosis across two force platforms set in a wooden walkway, and body kinematics and ground reaction force profiles in the sagittal plane were simultaneously recorded. We found that the forward tilting angle of the trunk at the time of toe-off of the leg with the ankle-foot orthosis was significantly larger than that of the leg without the ankle-foot orthosis, to adaptively compensate for the loss of ankle joint mobility due to the unilateral ankle-foot orthosis. Furthermore, the peak vertical ground reaction force at heel-contact was significantly larger in the leg without the ankle-foot orthosis than in the leg with the ankle-foot orthosis owing to the fact that the stance phase duration of the leg with the ankle-foot orthosis was relatively shorter. Such information may potentially be applied to facilitate walking training in stroke patients wearing a unilateral ankle-foot orthosis.

The evaluation of modified foot orthosis on muscle activity and kinetic in a subject with flexible flat foot : Single case study

2013 ◽  
Vol 38 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Hassan Saeedi ◽  
Mohammad E Mousavi ◽  
Basir Majddoleslam ◽  
Mehdi Rahgozar ◽  
Gholamreza Aminian ◽  
...  
Keyword(s):  
Ground Reaction Force ◽  
Muscle Activity ◽  
Sagittal Plane ◽  
Single Case ◽  
Reaction Force ◽  
Vertical Ground Reaction Force ◽  
Flat Foot ◽  
Case Evaluation ◽  
The University ◽  
Foot Orthosis

Background:Due to blocking of pronation/dorsiflexion in flexible flat foot and restriction of these movements in using the University of California Berkeley Laboratory orthosis, provided pressures in sole by the orthosis were increased. Therefore, this article describes the evaluation of modified foot orthosis with flexible structure in the management of individuals with flexible flat foot.Case description and method:The patient was a 21-year-old male who had symptomatic flat foot. The modified foot orthosis included movable surface and the outside structure. The modified foot orthosis was evaluated by standing foot X-ray, comfort rate, electromyography of leg muscle and vertical ground reaction force during walking.Findings and outcomes:The modified foot orthosis improved the foot alignment and decreased the symptoms of flat foot with more comfort. Subtalar position by sub-maximum supination had higher position than neutral in sagittal plane. It may increase the muscle activity of peroneus longus by 7% compared to barefoot, and there was a decrease of 11% ground reaction force in mid stance.Conclusion:The result of this single case evaluation only proposed the feasibility of this modified insole as the orthotic treatment in flexible flat foot.Clinical relevanceThe modified foot orthosis, which is mobile in the midfoot, is an orthosis for walking and standing in subjects with flexible flat foot.

Limb Dominance Related to the Variability and Symmetry of the Vertical Ground Reaction Force and Center of Pressure

2012 ◽  
Vol 28 (4) ◽  
pp. 473-478 ◽  
Author(s):  
Yun Wang ◽  
Kazuhiko Watanabe
Keyword(s):  
Ground Reaction Force ◽  
Center Of Pressure ◽  
Reaction Force ◽  
Rehabilitation Program ◽  
Vertical Ground Reaction Force ◽  
Foot Pressure ◽  
Walking Gait ◽  
Posterior Direction ◽  
Vertical Ground ◽  
Limb Dominance

The notion of limb dominance has been commonly used in the upper extremity, yet the two lower extremities are often treated as equal for analytical purposes. Attempts to determine the effects of limb laterality on gait have produced conflicting results. The purpose of this study was to determine if limb dominance affects the vertical ground reaction force and center of pressure (COP) during able-bodied gait. The Parotec system (Paromed GmbH, Germany) was used to collect plantar foot pressure data. Fifteen subjects volunteered to participate in this study. The coefficient of variation of the COP displacement in the mediolateral direction and the variability of peak force beneath the lateral forefoot in the nondominant foot were significant greater than in the dominant foot. Moreover, COP velocity in the anterior-posterior direction during the terminal stance phase showed greater value in the dominant foot. Our study provides support for limb laterality by showing limb dominance affected the vertical ground reaction force and center of pressure during walking gait. This finding suggests it is an important issue in movement science for clinicians and would assist in improving sports performance and rehabilitation program.

Development of a Dynamic Knee Actuator for a KAFO Using Superelastic Alloys

2014 ◽  
Author(s):  
Feng Tian ◽  
Mohamed Samir Hefzy ◽  
Mohammad Elahinia
Keyword(s):  
Knee Joint ◽  
Gait Cycle ◽  
Swing Phase ◽  
Walking Ability ◽  
Knee Motion ◽  
Walking Gait ◽  
Ankle Foot Orthosis ◽  
Stance Control ◽  
In Series ◽  
Foot Orthosis

A knee-ankle-foot orthosis (KAFO), which covers the knee, ankle and foot, can mitigate abnormal walking pattern caused by weak quadriceps. Several types of KAFOs are currently available in the market: passive KAFOs, stance-control KAFOs and dynamic KAFOs. In passive KAFOs, the knee joint keeps being locked during standing and walking, and can be unlocked manually to allow free rotation for sitting. Stance-control KAFOs (SCKAFOs) allow free knee motion during swing phase when the braced leg is unloaded. Dynamic KAFOs are able to reproduce normal walking ability throughout whole gait cycle. This research is directed at using superelastic alloys to develop a dynamic knee actuator that can be mounted on a traditional passive KAFO. The actuator stiffness can match that of a normal knee joint during the walking gait cycle. This proposed knee actuator utilizes a storing-releasing energy method to apply functional compensation to the knee joint, controlling the knee joint during both stance and swing phases. Fundamentally, the knee actuator is composed of two distinct parts which are connected with the thigh and shank segments, respectively. There are two superelastic actuators that are housed within these two parts and activated independently. Each actuator is developed by combining a superelastic rod and a rotary spring in series. When neither actuator is engaged, the knee joint is allowed to rotate freely. The stance actuator works only in the stance phase and the swing actuator is active for the swing phase. The conceptual design of the knee actuator is verified using numerical simulation and a prototype is developed through additive manufacturing for confirming the concept.

scholarly journals Restrictions in Ankle Dorsiflexion Range of Motion Alter Landing Kinematics But Not Movement Strategy When Fatigued

2020 ◽  
pp. 1-9
Author(s):  
Louis Howe ◽  
Jamie S. North ◽  
Mark Waldron ◽  
Theodoros M. Bampouras
Keyword(s):  
Ground Reaction Force ◽  
Knee Flexion ◽  
Sagittal Plane ◽  
Reaction Force ◽  
Ankle Dorsiflexion ◽  
Initial Contact ◽  
Vertical Ground Reaction Force ◽  
Recreational Athletes ◽  
Restricted Group ◽  
Vertical Ground

Context: Ankle dorsiflexion range of motion (DF ROM) has been associated with a number of kinematic and kinetic variables associated with landing performance that increase injury risk. However, whether exercise-induced fatigue exacerbates compensatory strategies has not yet been established. Objectives: (1) Explore differences in landing performance between individuals with restricted and normal ankle DF ROM and (2) identify the effect of fatigue on compensations in landing strategies for individuals with restricted and normal ankle DF ROM. Design: Cross-sectional. Setting: University research laboratory. Patients or Other Participants: Twelve recreational athletes with restricted ankle DF ROM (restricted group) and 12 recreational athletes with normal ankle DF ROM (normal group). Main Outcome Measure(s): The participants performed 5 bilateral drop-landings, before and following a fatiguing protocol. Normalized peak vertical ground reaction force, time to peak vertical ground reaction force, and loading rate were calculated, alongside sagittal plane initial contact angles, peak angles, and joint displacement for the ankle, knee, and hip. Frontal plane projection angles were also calculated. Results: At the baseline, the restricted group landed with significantly less knee flexion (P = .005, effect size [ES] = 1.27) at initial contact and reduced peak ankle dorsiflexion (P < .001, ES = 1.67), knee flexion (P < .001, ES = 2.18), and hip-flexion (P = .033, ES = 0.93) angles. Sagittal plane joint displacement was also significantly less for the restricted group for the ankle (P < .001, ES = 1.78), knee (P < .001, ES = 1.78), and hip (P = .028, ES = 0.96) joints. Conclusions: These findings suggest that individuals with restricted ankle DF ROM should adopt different landing strategies than those with normal ankle DF ROM. This is exacerbated when fatigued, although the functional consequences of fatigue on landing mechanics in individuals with ankle DF ROM restriction are unclear.

scholarly journals An Endurance-Dominated Exercise Program Improves Maximum Oxygen Consumption, Ground Reaction Forces, and Muscle Activities in Patients With Moderate Diabetic Neuropathy

2021 ◽  
Vol 12 ◽  
Author(s):  
AmirAli Jafarnezhadgero ◽  
Elahe Mamashli ◽  
Urs Granacher
Keyword(s):  
Ground Reaction Force ◽  
Reaction Force ◽  
Exercise Program ◽  
Ground Reaction Forces ◽  
Vertical Ground Reaction Force ◽  
Significant Group ◽  
Heel Contact ◽  
Reaction Forces ◽  
Vertical Ground ◽  
Post Hoc

BackgroundThe prevalence of diabetes worldwide is predicted to increase from 2.8% in 2000 to 4.4% in 2030. Diabetic neuropathy (DN) is associated with damage to nerve glial cells, their axons, and endothelial cells leading to impaired function and mobility.ObjectiveWe aimed to examine the effects of an endurance-dominated exercise program on maximum oxygen consumption (VO2max), ground reaction forces, and muscle activities during walking in patients with moderate DN.MethodsSixty male and female individuals aged 45–65 years with DN were randomly assigned to an intervention (IG, n = 30) or a waiting control (CON, n = 30) group. The research protocol of this study was registered with the Local Clinical Trial Organization (IRCT20200201046326N1). IG conducted an endurance-dominated exercise program including exercises on a bike ergometer and gait therapy. The progressive intervention program lasted 12 weeks with three sessions per week, each 40–55 min. CON received the same treatment as IG after the post-tests. Pre- and post-training, VO2max was tested during a graded exercise test using spiroergometry. In addition, ground reaction forces and lower limbs muscle activities were recorded while walking at a constant speed of ∼1 m/s.ResultsNo statistically significant baseline between group differences was observed for all analyzed variables. Significant group-by-time interactions were found for VO2max (p &lt; 0.001; d = 1.22). The post-hoc test revealed a significant increase in IG (p &lt; 0.001; d = 1.88) but not CON. Significant group-by-time interactions were observed for peak lateral and vertical ground reaction forces during heel contact and peak vertical ground reaction force during push-off (p = 0.001–0.037; d = 0.56–1.53). For IG, post-hoc analyses showed decreases in peak lateral (p &lt; 0.001; d = 1.33) and vertical (p = 0.004; d = 0.55) ground reaction forces during heel contact and increases in peak vertical ground reaction force during push-off (p &lt; 0.001; d = 0.92). In terms of muscle activity, significant group-by-time interactions were found for vastus lateralis and gluteus medius during the loading phase and for vastus medialis during the mid-stance phase, and gastrocnemius medialis during the push-off phase (p = 0.001–0.044; d = 0.54–0.81). Post-hoc tests indicated significant intervention-related increases in vastus lateralis (p = 0.001; d = 1.08) and gluteus medius (p = 0.008; d = 0.67) during the loading phase and vastus medialis activity during mid-stance (p = 0.001; d = 0.86). In addition, post-hoc tests showed decreases in gastrocnemius medialis during the push-off phase in IG only (p &lt; 0.001; d = 1.28).ConclusionsThis study demonstrated that an endurance-dominated exercise program has the potential to improve VO2max and diabetes-related abnormal gait in patients with DN. The observed decreases in peak vertical ground reaction force during the heel contact of walking could be due to increased vastus lateralis and gluteus medius activities during the loading phase. Accordingly, we recommend to implement endurance-dominated exercise programs in type 2 diabetic patients because it is feasible, safe and effective by improving aerobic capacity and gait characteristics.

Artificial Neural Network Based on Ensemble Empirical Mode Decomposition Features for Human Gait Diagnosis and Classification

2020 ◽  
Author(s):  
Rami Alkhatib ◽  
Mohamad O. Diab ◽  
Christophe Corbier ◽  
Mohamed El Badaoui
Keyword(s):  
Neural Network ◽  
Ground Reaction Force ◽  
Reaction Force ◽  
The Elderly ◽  
Ensemble Empirical Mode Decomposition ◽  
Human Gait ◽  
Walking Ability ◽  
Intrinsic Mode Functions ◽  
Vertical Ground Reaction Force ◽  
Mode Decomposition

Abstract Human gait analysis has been widely used to assess the stage of disease affecting the walking ability. The gait signals, namely vertical ground reaction force signals, become more unsteady and non-linear with the progress of the disease. This paper makes use of ground reaction force signals measured from both normal and subjects diagnosed with Parkinson. New features are then extracted from different intrinsic mode functions as a result of the ensemble mode decomposition. The extracted features are divided randomly into a training set of 60%, a validation set of 15% and testing set of 25%. The neural network is then employed which yield an interesting overall classification accuracy of 95.7 %. This paper will pave the way for better rehabilitative programs, understanding of gait biomechanics and fall prevention among the elderly.

scholarly journals Assessing Infant Carriage Systems: Ground Reaction Force Implications for Gait of the Caregiver

2017 ◽  
Vol 60 (2) ◽  
pp. 160-171 ◽  
Author(s):  
Mathew B. Brown ◽  
Caroline J. Digby-Bowl ◽  
Samuel D. Todd
Keyword(s):  
Ground Reaction Force ◽  
Repeated Measures ◽  
Reaction Force ◽  
Flat Foot ◽  
Walking Gait ◽  
Paired Samples ◽  
Heel Contact ◽  
Temporal Measures ◽  
Mixed Gender ◽  
Over Ground Walking

Objective To assess the acute alterations of anterior infant carriage systems on the ground reaction force experienced during over-ground walking. Background Previous research has identified the alterations in posture and gait associated with an increased anterior load (external or internal); however, the forces applied to the system due to the altered posture during over-ground walking have not been established. Method Thirteen mixed gender participants completed 45 over-ground walking trials at a self-selected pace under three loaded conditions (unloaded, semi-structured carrier 9.9 kg, and structured carrier 9.9 kg). Each trial consisted of a 15-m walkway, centered around a piezoelectric force platform sampling at 1,200 Hz. Differences were assessed between loaded and unloaded conditions and across carriers using paired samples t tests and repeated measures ANOVA. Results Additional load increased all ground reaction force parameters; however, the magnitude of force changes was influenced by carrier structure. The structured carrier displayed increased force magnitudes, a reduction in the time to vertical maximum heel contact, and an increased duration of the flat foot phase in walking gait. Conclusion Evidence suggests that the acute application of anterior infant carriers alters both kinetic and temporal measures of walking gait. Importantly, these changes appear to be governed not solely by the additional mass but also by the structure of the carrier. Application These findings indicate carrier structure should be considered by the wearer and may be used to inform policy in the recommendation of anterior infant carriage systems use by caregivers.

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