scholarly journals Effect of Peroneal Electrical Stimulation Versus an Ankle-Foot Orthosis on Obstacle Avoidance Ability in People With Stroke-Related Foot Drop

2012 ◽  
Vol 92 (3) ◽  
pp. 398-406 ◽  
Author(s):  
Roos van Swigchem ◽  
Hanneke J.R. van Duijnhoven ◽  
Jasper den Boer ◽  
Alexander C. Geurts ◽  
Vivian Weerdesteyn
Keyword(s):  
Electrical Stimulation ◽  
Muscle Strength ◽  
Obstacle Avoidance ◽  
Community Dwelling ◽  
Foot Drop ◽  
Walking Ability ◽  
Success Rates ◽  
Ankle Foot Orthosis ◽  
Leg Muscle ◽  
Foot Orthosis

Background Walking ability of people with foot drop in the chronic phase after stroke is better with functional electrical stimulation (FES) of the peroneal nerve than without an orthotic device. However, the literature is not conclusive on whether peroneal FES also is better than an ankle-foot orthosis (AFO) in this regard. Objective This study aimed to identify potential benefits of peroneal FES over an AFO with respect to the ability to negotiate a sudden obstacle. Design The study design was a within-subject comparison between FES and AFO using repeated measures. Methods Twenty-four community-dwelling people with stroke (mean age=52.6 years, SD=12.7) who regularly used a polypropylene AFO were fitted with a transcutaneous FES device. The participants' obstacle avoidance ability was tested after 2 and 8 weeks. They had to avoid 30 obstacles that were suddenly dropped on a treadmill in front of the affected leg while walking with either FES or an AFO. The obstacle avoidance success rates were determined. Results Success rates were higher with FES than with an AFO, especially after adjustment for individual leg muscle strength. Participants with relatively low muscle strength (Motricity Index score <64) were most likely to benefit from FES regarding obstacle avoidance ability. Limitation Further work is needed to determine whether the results may be generalized to other groups of people with stroke. Conclusions Peroneal FES seems to be superior to an AFO with regard to obstacle avoidance ability in community-dwelling people with stroke. The observed gains in obstacle avoidance ability appear to be clinically most relevant in the people with relatively low leg muscle strength.

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

2014 ◽  
Vol 94 (5) ◽  
pp. 654-663 ◽  
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.

scholarly journals A sock for foot-drop: A preliminary study on two chronic stroke patients

2013 ◽  
Vol 38 (5) ◽  
pp. 425-430
Author(s):  
Sarah Prenton ◽  
Laurence PJ Kenney ◽  
Glen Cooper ◽  
Matthew J Major
Keyword(s):  
Single Case ◽  
Motor Impairment ◽  
Chronic Stroke ◽  
Community Dwelling ◽  
Foot Drop ◽  
Attractive Alternative ◽  
Stroke Patients ◽  
Ankle Foot Orthosis ◽  
General Improvement ◽  
Foot Orthosis

Background: Foot-drop is a common motor impairment of chronic stroke patients, which may be addressed with an ankle foot orthosis. Although there is reasonable evidence of effectiveness for ankle foot orthoses, user compliance is sometimes poor. This study investigated a new alternative to the ankle foot orthosis, the dorsiflex sock. Case description and methods: The dorsiflex sock was evaluated using an A-B single case experimental design. Two community-dwelling, chronic stroke patients with foot-drop participated in this study. Measures were selected to span the International Classification of Function, Disability and Health domains and user views on the dorsiflex sock were also collected. Findings and outcomes: The dorsiflex sock was not effective in improving participants’ walking symmetry, speed or energy expenditure. Participant 1 showed improvement in the distance he could walk in 6 min when using the dorsiflex sock, but this was in keeping with a general improvement trend over the course of this study. However, both participants viewed the dorsiflex sock positively and reported a positive effect on their walking. Conclusion: Despite positive user perceptions, the study found no clear evidence that dorsiflex sock is effective in improving foot-drop. Clinical relevance Although the dorsiflex sock offers an attractive alternative to an ankle foot orthosis, the case studies found no clear evidence of its efficacy. Clinicians should view this device with caution until further research becomes available.

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

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.

Surplus value of implanted peroneal functional electrical stimulation over ankle-foot orthosis for gait adaptability in people with foot drop after stroke

2019 ◽  
Vol 71 ◽  
pp. 157-162 ◽  
Author(s):  
Frank Berenpas ◽  
Alexander C. Geurts ◽  
Jasper den Boer ◽  
Roos van Swigchem ◽  
Frans Nollet ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Foot Drop ◽  
Surplus Value ◽  
Ankle Foot Orthosis ◽  
Foot Orthosis

scholarly journals Comparison of walking energy cost between an anterior and a posterior ankle-foot orthosis in people with foot drop

2014 ◽  
Vol 46 (8) ◽  
pp. 768-772 ◽  
Author(s):  
F Menotti ◽  
L Laudani ◽  
A Damiani ◽  
P Orlando ◽  
A Macaluso
Keyword(s):  
Energy Cost ◽  
Foot Drop ◽  
Ankle Foot Orthosis ◽  
Foot Orthosis ◽  
Walking Energy Cost

Customized design and additive manufacturing of kids’ ankle foot orthosis

2020 ◽  
Vol 26 (10) ◽  
pp. 1677-1685 ◽  
Author(s):  
Harish Kumar Banga ◽  
Parveen Kalra ◽  
Rajendra M. Belokar ◽  
Rajesh Kumar
Keyword(s):  
Mechanical Properties ◽  
Additive Manufacturing ◽  
3D Printing ◽  
Gait Cycle ◽  
Foot Drop ◽  
Human Gait ◽  
Content Type ◽  
Ankle Foot Orthosis ◽  
New Material ◽  
Foot Orthosis

Purpose The purpose of this study is improvement of human gait by customized design of ankle foot orthosis (AFO). An has been the most frequently used orthosis in children with cerebral palsy. AFOs are designed to boost existing features or to avoid depression or traumatize muscle contractures. The advantages of AFO’s utilized for advancement in human walk attributes for the improvement in foot deformities patients or youngsters with spastic loss of motion. In this research on the customized design of AFO's to improve gait, there are limitations during walking of foot drop patients. In children with foot drops, specific AFOs were explicitly altered to improve parity and strength which are beneficial to walking positions. Design/methodology/approach This study proposes the customized design of AFOs using computerized and additive manufacturing for producing advances to alter the design and increase comfort for foot drop patients. Structuring the proposed design fabricated by using additive manufacturing and restricted material, the investigation was finalized at the Design Analysis Software (ANSYS). The system that performs best under investigation can additionally be printed using additive manufacturing. Findings The results show that the customized design of AFOs meets the patient’s requirements and could also be an alternative solution to the existing AFO design. The biomechanical consequences and mechanical properties of additive manufactured AFOs have been comparable to historically synthetic AFOs. While developing the novel AFO designs, the use of 3D printing has many benefits, including stiffness and weight optimization, to improve biomechanical function and comfort. To defeat the issues of foot drop patients, a customized AFO is used to improve the human gait cycle with new material and having better mechanical properties. Originality/value This research work focuses on the biomechanical impacts and mechanical properties of customized 3D-printed AFOs and compares them to traditionally made AFOs. Customized AFO design using 3D printing has numerous potential advantages, including new material with lightweight advancement, to improve biomechanical function and comfort. Normally, new applications mean an incremental collection of learning approximately the behavior of such gadgets and blending the new design, composite speculation and delivered substance production. The test results aim to overcome the new AFO structure issues and display the limited components and stress examination. The outcome of the research is the improved gait cycle of foot drop patients.

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