scholarly journals The Importance of Being Earnest about Shank and Thigh Kinematics Especially When Using Ankle-Foot Orthoses

2010 ◽  
Vol 34 (3) ◽  
pp. 254-269 ◽  
Author(s):  
Elaine Owen
Keyword(s):  
Joint Kinematics ◽  
Foot Orthoses ◽  
Traditional Beliefs ◽  
Vertical Angle ◽  
Gait Biomechanics ◽  
Normal Gait ◽  
Ankle Foot Orthoses ◽  
Pathological Gait ◽  
Kinematics And Kinetics

This paper reviews and summarizes the evidence for important observations of normal and pathological gait and presents an approach to rehabilitation and orthotic management, which is based on the significance of shank and thigh kinematics for standing and gait. It discusses normal gait biomechanics, challenging some traditional beliefs, the interrelationship between segment kinematics, joint kinematics and kinetics and their relationship to orthotic design, alignment and tuning. It proposes a description of four rather than three rockers in gait; a simple categorization of pathological gait based on shank kinematics abnormality; an algorithm for the designing, aligning and tuning of AFO-Footwear Combinations; and an algorithm for determining the sagittal angle of the ankle in an AFO. It reports the results of research on Shank to Vertical Angle alignment of tuned AFO-Footwear Combinations and on the use of ‘point loading’ rocker soles.

scholarly journals Effects of Ankle Foot Orthoses on the Gait Patterns in Children with Spastic Bilateral Cerebral Palsy: A Scoping Review

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 903
Author(s):  
Diogo Ricardo ◽  
Maria Raposo ◽  
Eduardo Cruz ◽  
Raul Oliveira ◽  
Filomena Carnide ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Scientific Data ◽  
Cochrane Library ◽  
Leaf Spring ◽  
Foot Orthoses ◽  
Gait Patterns ◽  
Functional Scores ◽  
Ankle Foot Orthoses ◽  
Pathological Gait ◽  
The Impact

Background: Cerebral palsy (CP) is the most common cause of motor disability in children and can cause severe gait deviations. The sagittal gait patterns classification for children with bilateral CP is an important guideline for the planning of the rehabilitation process. Ankle foot orthoses should improve the biomechanical parameters of pathological gait in the sagittal plane. Methods: A systematic search of the literature was conducted to identify randomized controlled trials (RCT) and controlled clinical trials (CCT) which measured the effect of ankle foot orthoses (AFO) on the gait of children with spastic bilateral CP, with kinetic, kinematic, and functional outcomes. Five databases (Pubmed, Scopus, ISI Web of SCIENCE, SciELO, and Cochrane Library) were searched before February 2020. The PEDro Score was used to assess the methodological quality of the selected studies and alignment with the Cochrane approach was also reviewed. Prospero registration number: CRD42018102670. Results: We included 10 studies considering a total of 285 children with spastic bilateral CP. None of the studies had a PEDro score below 4/10, including five RCTs. We identified five different types of AFO (solid; dynamic; hinged; ground reaction; posterior leaf spring) used across all studies. Only two studies referred to a classification for gait patterns. Across the different outcomes, significant differences were found in walking speed, stride length and cadence, range of motion, ground force reaction and joint moments, as well as functional scores, while wearing AFO. Conclusions: Overall, the use of AFO in children with spastic bilateral CP minimizes the impact of pathological gait, consistently improving some kinematic, kinetic, and spatial-temporal parameters, and making their gait closer to that of typically developing children. Creating a standardized protocol for future studies involving AFO would facilitate the reporting of new scientific data and help clinicians use their clinical reasoning skills to recommend the best AFO for their patients.

The effect of tuning ankle foot orthoses–footwear combination on the gait parameters of children with cerebral palsy

2012 ◽  
Vol 37 (2) ◽  
pp. 95-107 ◽  
Author(s):  
Nicola Eddison ◽  
Nachiappan Chockalingam
Keyword(s):  
Cerebral Palsy ◽  
Foot Orthoses ◽  
Ankle Foot Orthosis ◽  
Gait Parameters ◽  
Ankle Foot Orthoses ◽  
Children With Cerebral Palsy ◽  
Within Subjects ◽  
Kinetics Of ◽  
Kinematics And Kinetics ◽  
Foot Orthosis

Background:There are a wide variety of ankle foot orthoses used in clinical practice which are characterised by their design, the material used and the stiffness of that material. Changing any of these three components will alter the effect of the ankle foot orthosis on gait.Objectives:The purpose of this article is to provide an overview on the available research on ankle foot orthosis–footwear combination tuning on the gait characteristics of children with cerebral palsy through a structured review.Study Design:Literature review.Methods:A thorough search of previous studies published in English was conducted within all major databases using relevant phrases without any limits for the dates. These searches were then supplemented by tracking all key references from the appropriate articles identified including hand searching of published books where relevant.Results:To date, there are 947 papers in the literature pertaining to the study of ankle foot orthosis. Of these, 153 investigated the use of ankle foot orthosis for children with cerebral palsy. All the studies included in this review were of a within-subjects design and the evidence levels were generally low.Conclusions:The overall results suggested that ankle foot orthosis–footwear combination tuning has the potential to improve the kinematics and kinetics of gait in children with cerebral palsy. However, the review highlights a lack of well-designed and adequately powered studies.Clinical relevanceWhile the research described in this article indicates an improvement in the gait of children with cerebral palsy following tuning of their ankle foot orthosis–footwear combination, there is still a paucity of research with quantitative data on the effects of kinematics and kinetics of ankle foot orthosis–footwear combination tuning, comparing untuned ankle foot orthosis–footwear combinations with tuned ankle foot orthosis–footwear combination. Furthermore, current research does not identify the effect of tuning on energy efficiency.

scholarly journals Shank-to-Vertical Angle in Ankle-Foot Orthoses

2017 ◽  
Vol 29 (4) ◽  
pp. 161-167 ◽  
Author(s):  
Nicola Eddison ◽  
Aoife Healy ◽  
Robert Needham ◽  
Nachiappan Chockalingam
Keyword(s):  
Foot Orthoses ◽  
Vertical Angle ◽  
Ankle Foot Orthoses

Effects of Rigid and Dynamic Ankle-Foot Orthoses on Normal Gait

2009 ◽  
Vol 30 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Bastien Guillebastre ◽  
Paul Calmels ◽  
Patrice Rougier
Keyword(s):  
Foot Orthoses ◽  
Normal Gait ◽  
Ankle Foot Orthoses

The Shank-to-Vertical-Angle as a parameter to evaluate tuning of Ankle-Foot Orthoses

2015 ◽  
Vol 42 (3) ◽  
pp. 269-274 ◽  
Author(s):  
Yvette L. Kerkum ◽  
Han Houdijk ◽  
Merel-Anne Brehm ◽  
Annemieke I. Buizer ◽  
Manon L.C. Kessels ◽  
...  
Keyword(s):  
Foot Orthoses ◽  
Vertical Angle ◽  
Ankle Foot Orthoses

scholarly journals Individual stiffness optimization of dorsal leaf spring ankle–foot orthoses in people with calf muscle weakness is superior to standard bodyweight-based recommendations

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Niels F. J. Waterval ◽  
Merel-Anne Brehm ◽  
Jaap Harlaar ◽  
Frans Nollet
Keyword(s):  
Muscle Weakness ◽  
Energy Cost ◽  
Activity Level ◽  
Calf Muscle ◽  
Leaf Spring ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses ◽  
The Individual ◽  
Optimal Stiffness ◽  
Walking Energy Cost

Abstract Background In people with calf muscle weakness, the stiffness of dorsal leaf spring ankle–foot orthoses (DLS-AFO) needs to be individualized to maximize its effect on walking. Orthotic suppliers may recommend a certain stiffness based on body weight and activity level. However, it is unknown whether these recommendations are sufficient to yield the optimal stiffness for the individual. Therefore, we assessed whether the stiffness following the supplier’s recommendation of the Carbon Ankle7 (CA7) dorsal leaf matched the experimentally optimized AFO stiffness. Methods Thirty-four persons with calf muscle weakness were included and provided a new DLS-AFO of which the stiffness could be varied by changing the CA7® (Ottobock, Duderstadt, Germany) dorsal leaf. For five different stiffness levels, including the supplier recommended stiffness, gait biomechanics, walking energy cost and speed were assessed. Based on these measures, the individual experimentally optimal AFO stiffness was selected. Results In only 8 of 34 (23%) participants, the supplier recommended stiffness matched the experimentally optimized AFO stiffness, the latter being on average 1.2 ± 1.3 Nm/degree more flexible. The DLS-AFO with an experimentally optimized stiffness resulted in a significantly lower walking energy cost (− 0.21 ± 0.26 J/kg/m, p < 0.001) and a higher speed (+ 0.02 m/s, p = 0.003). Additionally, a larger ankle range of motion (+ 1.3 ± 0.3 degrees, p < 0.001) and higher ankle power (+ 0.16 ± 0.04 W/kg, p < 0.001) were found with the experimentally optimized stiffness compared to the supplier recommended stiffness. Conclusions In people with calf muscle weakness, current supplier’s recommendations for the CA7 stiffness level result in the provision of DLS-AFOs that are too stiff and only achieve 80% of the reduction in energy cost achieved with an individual optimized stiffness. It is recommended to experimentally optimize the CA7 stiffness in people with calf muscle weakness in order to maximize treatment outcomes. Trial registration Nederlands Trial Register 5170. Registration date: May 7th 2015. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5170.

State of the Art Review of Knee–Ankle–Foot Orthoses

2015 ◽  
Vol 43 (2) ◽  
pp. 427-441 ◽  
Author(s):  
Feng Tian ◽  
Mohamed Samir Hefzy ◽  
Mohammad Elahinia
Keyword(s):  
State Of The Art ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses

scholarly journals The Effects of Repetitive Drop Jumps on Impact Phase Joint Kinematics and Kinetics

2011 ◽  
Vol 27 (2) ◽  
pp. 108-115 ◽  
Author(s):  
Joshua T. Weinhandl ◽  
Jeremy D. Smith ◽  
Eric L. Dugan
Keyword(s):  
Energy Absorption ◽  
Plantar Flexion ◽  
Knee Extension ◽  
Joint Kinematics ◽  
Knee Extensors ◽  
Initial Contact ◽  
Drop Jumps ◽  
Impact Phase ◽  
The Impact ◽  
Kinematics And Kinetics

The purpose of the study was to investigate the effects of fatigue on lower extremity joint kinematics, and kinetics during repetitive drop jumps. Twelve recreationally active males (n= 6) and females (n= 6) (nine used for analysis) performed repetitive drop jumps until they could no longer reach 80% of their initial drop jump height. Kinematic and kinetic variables were assessed during the impact phase (100 ms) of all jumps. Fatigued landings were performed with increased knee extension, and ankle plantar flexion at initial contact, as well as increased ankle range of motion during the impact phase. Fatigue also resulted in increased peak ankle power absorption and increased energy absorption at the ankle. This was accompanied by an approximately equal reduction in energy absorption at the knee. While the knee extensors were the muscle group primarily responsible for absorbing the impact, individuals compensated for increased knee extension when fatigued by an increased use of the ankle plantar flexors to help absorb the forces during impact. Thus, as fatigue set in and individuals landed with more extended lower extremities, they adopted a landing strategy that shifted a greater burden to the ankle for absorbing the kinetic energy of the impact.

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