scholarly journals PERFORMANCE, PATIENT BENEFITS AND ACCEPTANCE OF A NEW GENERATION OF MICROPROCESSOR-CONTROLLED STANCE AND SWING CONTROL ORTHOSIS

2018 ◽  
Author(s):  
Nadine Wismer ◽  
OA Alexander Krebs ◽  
Frank Braatz ◽  
Thomas Schmalz ◽  
Andreas Kranzl ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Weight Bearing ◽  
Swing Phase ◽  
Anatomic Structure ◽  
National Assembly ◽  
Ankle Foot Orthosis ◽  
Stance Control ◽  
Locked Knee ◽  
Physiological Values ◽  
New Generation

INTRODUCTION By enabling users to flex the orthotic leg during swing phase and safely lock it during stance phase, stance control orthosis (SCO) offers clear benefits compared to locked knee-ankle-foot-orthosis (KAFO)1. Since such orthoses do not offer dampened knee flexion in the weight-bearing condition, this represents a limitation in everyday activities such as ramp and stair descent. C-Brace, a microprocessor controlled stance and swing orthosis (SSCO), overcomes many of those problems. Maximum knee flexion angle in stance and swing phase during level walking are closer to physiological values with C-Brace compared to conventional KAFOs2. The patients are with C-Brace able to descend stairs and ramps reciprocally2. Furthermore, patients report of safer and easier ability to perform activities of daily living3. The main aim of next generation C-Brace is a reduction in size and an increase of adaptability to the patient’s anatomic structure. Due to technological changes, improvements especially for difficult ADLs (e.g. walking on uneven ground) are expected. Abstract PDF  Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/32020/24438 How to cite: Wismer N, Krebs A, Braatz F, Schmalz T, Kranzl A, Breuer C. PERFORMANCE, PATIENT BENEFITS AND ACCEPTANCE OF A NEW GENERATION OF MICROPROCESSOR-CONTROLLED STANCE AND SWING CONTROL ORTHOSIS. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, POSTER PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018.DOI: https://doi.org/10.33137/cpoj.v1i2.32020 Abstracts were Peer-reviewed by the American Orthotic Prosthetic Association (AOPA) 101st National Assembly Scientific Committee.  http://www.aopanet.org/

A functional comparison of conventional knee–ankle–foot orthoses and a microprocessor-controlled leg orthosis system based on biomechanical parameters

2014 ◽  
Vol 40 (2) ◽  
pp. 277-286 ◽  
Author(s):  
Thomas Schmalz ◽  
Eva Pröbsting ◽  
Roland Auberger ◽  
Gordon Siewert
Keyword(s):  
Knee Flexion ◽  
Weight Bearing ◽  
Swing Phase ◽  
Flexion Angle ◽  
Foot Orthoses ◽  
Joint Moments ◽  
Level Walking ◽  
Stance Control ◽  
Ankle Foot Orthoses ◽  
Biomechanical Parameters

Background: The microprocessor-controlled leg orthosis C-Brace enables patients with paretic or paralysed lower limb muscles to use dampened knee flexion under weight-bearing and speed-adapted control of the swing phase. Objectives: The objective of the present study was to investigate the new technical functions of the C-Brace orthosis, based on biomechanical parameters. Study design: The study enrolled six patients. The C-Brace orthosis is compared with conventional leg orthoses (four stance control orthoses, two locked knee–ankle–foot orthoses) using biomechanical parameters of level walking, descending ramps and descending stairs. Methods: Ground reaction forces, joint moments and kinematic parameters were measured for level walking as well as ascending and descending ramps and stairs. Results: With the C-Brace, a nearly natural stance phase knee flexion was measured during level walking (mean value 11° ± 5.6°). The maximum swing phase knee flexion angle of the C-Brace approached the normal value of 65° more closely than the stance control orthoses (66° ± 8.5° vs 74° ± 6.4°). No significant differences in the joint moments were found between the C-Brace and stance control orthosis conditions. In contrast to the conventional orthoses, all patients were able to ambulate ramps and stairs using a step-over-step technique with C-Brace (flexion angle 64.6° ± 8.2° and 70.5° ± 12.4°). Conclusion: The results show that the functions of the C-Brace for situation-dependent knee flexion under weight bearing have been used by patients with a high level of confidence. Clinical relevance The functional benefits of the C-Brace in comparison with the conventional orthotic mechanisms could be demonstrated most clearly for descending ramps and stairs. The C-Brace orthosis is able to combine improved orthotic function with sustained orthotic safety.

scholarly journals Evaluation of gait symmetry in poliomyelitis subjects: Comparison of a conventional knee–ankle–foot orthosis and a new powered knee–ankle–foot orthosis

2016 ◽  
Vol 40 (6) ◽  
pp. 689-695 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Fardin Ahmadi ◽  
Mahmood Bahramizadeh ◽  
Mohammad Samadian ◽  
Mohammad Ebrahim Mousavi ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Stance Phase ◽  
Swing Phase ◽  
Step Width ◽  
Gait Symmetry ◽  
Ankle Foot Orthosis ◽  
Swing Time ◽  
Locked Knee ◽  
Stance Time ◽  
Foot Orthosis

Background:Compared to able-bodied subjects, subjects with post-polio syndrome and poliomyelitis demonstrate a preference for weight-bearing on the non-paretic limb, causing gait asymmetry.Objectives:The purpose of this study was to evaluate the gait symmetry of the poliomyelitis subjects when ambulating with either a drop-locked knee–ankle–foot orthosis or a newly developed powered knee–ankle–foot orthosis.Study design:Quasi experimental study.Methods:Seven subjects with poliomyelitis who routinely wore conventional knee–ankle–foot orthoses participated in this study and received training to enable them to ambulate with the powered knee–ankle–foot orthosis on level ground, prior to gait analysis.Results:There were no significant differences in the gait symmetry index of step length ( p = 0.085), stance time ( p = 0.082), double-limb support time ( p = 0.929), or speed of walking ( p = 0.325) between the two test conditions. However, using the new powered knee–ankle–foot orthosis improved the symmetry index in step width ( p = 0.037), swing time ( p = 0.014), stance phase percentage ( p = 0.008), and knee flexion during swing phase ( p ⩽ 0.001) compared to wearing the drop-locked knee–ankle–foot orthosis.Conclusion:The use of a powered knee–ankle–foot orthosis for ambulation by poliomyelitis subjects affects gait symmetry in the base of support, swing time, stance phase percentage, and knee flexion during swing phase.Clinical relevanceA new powered knee–ankle–foot orthosis can improve gait symmetry for poliomyelitis subjects by influencing step width, swing time, stance time percentage, and knee flexion during swing phase when compared to ambulating with a drop-locked knee–ankle–foot orthosis.

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.

Ankle–foot orthosis with dorsiflexion resistance using spring-cam mechanism increases knee flexion in the swing phase during walking in stroke patients with hemiplegia

2020 ◽  
Vol 81 ◽  
pp. 27-32 ◽  
Author(s):  
Yusuke Sekiguchi ◽  
Dai Owaki ◽  
Keita Honda ◽  
Kenichiro Fukushi ◽  
Noriyoshi Hiroi ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Swing Phase ◽  
Stroke Patients ◽  
Ankle Foot Orthosis ◽  
Cam Mechanism ◽  
Foot Orthosis

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.

Feasibility of a Powered Knee Joint in Providing Stance and Swing Phase Knee Flexion when Using a Knee-Ankle-Foot Orthosis

2017 ◽  
Vol 29 (4) ◽  
pp. 177-182
Author(s):  
Masoud Rafiaei ◽  
Mokhtar Arazpour ◽  
Mahmood Bahramizadeh ◽  
Farzam Farahmand ◽  
Nima Jamshidi ◽  
...  
Keyword(s):  
Knee Joint ◽  
Knee Flexion ◽  
Swing Phase ◽  
Ankle Foot Orthosis ◽  
Foot Orthosis

scholarly journals Safety and walking ability of KAFO users with the C-Brace® Orthotronic Mobility System, a new microprocessor stance and swing control orthosis

2016 ◽  
Vol 41 (1) ◽  
pp. 65-77 ◽  
Author(s):  
Eva Pröbsting ◽  
Andreas Kannenberg ◽  
Britta Zacharias
Keyword(s):  
Activities Of Daily Living ◽  
Lower Limb ◽  
Daily Living ◽  
Foot Orthoses ◽  
Evaluation Questionnaire ◽  
Ankle Foot Orthosis ◽  
Stance Control ◽  
Ankle Foot Orthoses ◽  
Locked Knee ◽  
Foot Orthosis

Background: There are clear indications for benefits of stance control orthoses compared to locked knee ankle foot orthoses. However, stance control orthoses still have limited function compared with a sound human leg. Objectives: The aim of this study was to evaluate the potential benefits of a microprocessor stance and swing control orthosis compared to stance control orthoses and locked knee ankle foot orthoses in activities of daily living. Study design: Survey of lower limb orthosis users before and after fitting of a microprocessor stance and swing control orthosis. Methods: Thirteen patients with various lower limb pareses completed a baseline survey for their current orthotic device (locked knee ankle foot orthosis or stance control orthosis) and a follow-up for the microprocessor stance and swing control orthosis with the Orthosis Evaluation Questionnaire, a new self-reported outcome measure devised by modifying the Prosthesis Evaluation Questionnaire for use in lower limb orthotics and the Activities of Daily Living Questionnaire. Results: The Orthosis Evaluation Questionnaire results demonstrated significant improvements by microprocessor stance and swing control orthosis use in the total score and the domains of ambulation ( p = .001), paretic limb health ( p = .04), sounds ( p = .02), and well-being ( p = .01). Activities of Daily Living Questionnaire results showed significant improvements with the microprocessor stance and swing control orthosis with regard to perceived safety and difficulty of activities of daily living. Conclusion: The microprocessor stance and swing control orthosis may facilitate an easier, more physiological, and safer execution of many activities of daily living compared to traditional leg orthosis technologies. Clinical relevance This study compared patient-reported outcomes of a microprocessor stance and swing control orthosis (C-Brace) to those with traditional knee ankle foot orthosis and stance control orthosis devices. The C-Brace offers new functions including controlled knee flexion during weight bearing and dynamic swing control, resulting in significant improvements in perceived orthotic mobility and safety.

scholarly journals The Effect of Stance Control Orthoses on Gait Characteristics and Energy Expenditure in Knee-Ankle-Foot Orthosis Users

2010 ◽  
Vol 34 (2) ◽  
pp. 206-215 ◽  
Author(s):  
Priya Chantal Davis ◽  
Timothy Michael Bach ◽  
Darren Mark Pereira
Keyword(s):  
Energy Expenditure ◽  
Knee Joint ◽  
Knee Flexion ◽  
Foot Orthoses ◽  
Gait Characteristics ◽  
Stance Control ◽  
Ankle Foot Orthoses ◽  
Locked Knee ◽  
Control Knee ◽  
Walking Velocity

Stance Control knee-ankle foot orthoses (SCO) differ from their traditional locked knee counterparts by allowing free knee flexion during swing while providing stability during stance. It is widely accepted that free knee flexion during swing normalizes gait and therefore improves walking speed and reduces the energy requirements of walking. Limited research has been carried out to evaluate the benefits of SCOs when compared to locked knee-ankle foot orthoses (KAFOs). The purpose of this study was to evaluate the effectiveness of SCOs used for patients with lower limb pathology. Energy expenditure and walking velocity were measured in 10 subjects using an orthosis incorporating a Horton Stance Control knee joint. A GAITRite walkway was used to measure temporospatial gait characteristics. A Cosmed K4b2 portable metabolic system was used to measure energy expenditure and heart rate during walking. Two conditions were tested: Walking with stance control active (stance control) and walking with the knee joint locked. Ten subjects completed the GAITRite testing; nine subjects completed the Cosmed testing. Walking velocity was significantly increased in the stance control condition ( p < 0.001). There was no difference in the energy cost of walking ( p = 0.515) or physiological cost index (PCI) ( p = 0.093) between conditions. This study supports previous evidence that stance control knee-ankle foot orthoses increase walking velocity compared to locked knee devices. Contrary to expectation, the stance control condition did not decrease energy expenditure during walking.

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.

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