Comparative Impact Study between Two Different Orthotic Clinical Approaches of Shank Vertical Angle Alignment on GRF Vectors and Activation Profile of Tibialis Anterior in Subjects with Post Stroke Hemiplegic using Solid Ankle Foot Orthosis: A Prospective Study

2021 ◽  
Vol 11 (7) ◽  
pp. 69-80
Author(s):  
Shaliny Bandyopadhyay ◽  
Hasan Md. Arif Raihan ◽  
Harsh Kumar Kanhaiya
Keyword(s):  
Tibialis Anterior ◽  
Tibialis Anterior Muscle ◽  
Treatment Protocol ◽  
Outer Side ◽  
Ankle Foot Orthosis ◽  
Post Stroke ◽  
Emg Signal ◽  
Gait Parameters ◽  
Activation Profile ◽  
Foot Orthosis

Background: Stroke is defined as the sudden onset of a focal neurologic deficit due to a presumed local disturbance in the blood supply to the brain. Orthotic treatment protocol in post stroke hemiplegic patients still is controversial topic. Numerous previous studies are concentrated upon providing the posterior heel wedge in outer side mainly with footwear’s heel rising associated with molded Solid Ankle Foot Orthosis (SAFO) but this is an attempt of this study to check the effects of insole posterior heel wedge as well as outsole posterior heel wedge in SAFO on temporal and kinetic gait parameters and activation profile of tibialis anterior muscle in post stroke hemiplegic patients. Aim & Objectives: The aim of the study was to compare between insole and outsole posterior heel wedge in molded solid ankle foot orthosis on working efficiency and activation profile of tibialis anterior muscle of the subject with post stroke hemiplegia. Materials and Methods: 30 subjects with post stroke hemiplegia were included in this study by convenient sampling method. The subjects were given with solid ankle foot orthosis with insole and outsole posterior heel wedge. The temporal and kinetic gait parameters and EMG of T.A muscle was measured using eWalk-NILD (MAT), Force plate and AD instrument power Lab. All the measurements were acquired at the time of measurement (Baseline data), time of discharge (Pre data) and after 4 weeks Post data was taken. Results: Pre-post conditions GRF Fx,Fy,Fz have significantly differences. Some parameters also have the non-significant differences. For all the cases to assist the parameters pre and post condition associated with and without AFO with insole posterior heel wedges on Group A and outsole Posterior heel wedge on Group B values are respected for GRF Fx pre without AFO (p= .147), pre with AFO (p= .037) and post without AFO (p= .253) with AFO (p=.009) For Fy pre without and with AFO (p=.025), (p =.682), post without and with AFO (p= .000), (p= .524) in case of Fz pre without and with AFO (p= .759) , (p= .999) post without and with AFO (p=.117), (p=.404 ). On TA muscle profile have also significant differences between two groups on pre without and with AFO (p=.005), (p= .613) and post without and with AFO (p= .000), (p= .000). Discussion & Conclusion: As per present perspective clinical evident report it is concluded that molded SAFO with outsole posterior heel wedge have a significance impact for positive influences on GRF, without any deficit contraction ( EMG signal) of T.A. muscle profile, as compare to insole posterior wedge with AFO. Key words: Hemiplegic, Gait kinetic parameters, Molded ankle foot orthosis, Insole and Outsole Posterior Heel Wedge.

Kinematic and kinetic benefits of implantable peroneal nerve stimulation in people with post-stroke drop foot using an ankle-foot orthosis

2018 ◽  
Vol 36 (4) ◽  
pp. 547-558 ◽  
Author(s):  
Frank Berenpas ◽  
Sven Schiemanck ◽  
Anita Beelen ◽  
Frans Nollet ◽  
Vivian Weerdesteyn ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Peroneal Nerve ◽  
Drop Foot ◽  
Ankle Foot Orthosis ◽  
Post Stroke ◽  
Peroneal Nerve Stimulation ◽  
Foot Orthosis

scholarly journals Clinical experiences with a convertible thermoplastic knee-ankle-foot orthosis for post-stroke hemiplegic patients

1996 ◽  
Vol 20 (3) ◽  
pp. 191-194 ◽  
Author(s):  
S. Kakurai ◽  
M. Akai
Keyword(s):  
Gait Training ◽  
Inhibitory Effect ◽  
Clinical Experiences ◽  
Recovery Stage ◽  
Physical Impairments ◽  
Ankle Foot Orthosis ◽  
Post Stroke ◽  
Walking Pattern ◽  
Accepted Practice ◽  
Foot Orthosis

As rehabilitation for post-stroke hemiplegic patients has become widely accepted practice, there has been an increase in patients who are more difficult to treat. In the prescription rationale of orthoses for hemiplegics, the knee-ankle-foot orthosis (KAFO) for the lower limb has generally been underestimated because of its inhibitory effect on the normal walking pattern and also its interference with gait training. The authors had an experience of 28 hemiplegics with severe physical impairments who were fitted with a convertible plastic KAFO. Among these patients, there were 11 cases in which the KAFO was replaced by an ankle-foot orthosis (AFO) within 1.5 to 8 months (average 4 months) following initial prescription when they were able to control their knee actively. Ambulatory capability in these patients was superior to that of the remaining KAFO group. The Barthel index of the AFO group patients was higher than the KAFO group (p<0.01). However neither age, sex, severity of hemiplegia, starting time of rehabilitation following onset of stroke, time of fitting with the orthosis, nor the functional recovery stage were critical factors between the two groups, only the incidence of major complications affected ambulatory capability.

Immediate Effects of the Dorsiflexion Angle of Hinged Ankle-foot Orthosis on the Spatiotemporal Gait Parameters of Children With Spastic Cerebral Palsy

2021 ◽  
Author(s):  
IlHyun Son ◽  
GyuChang Lee
Keyword(s):  
Cerebral Palsy ◽  
Stride Length ◽  
Step Length ◽  
Gait Velocity ◽  
Spastic Cerebral Palsy ◽  
Spastic Diplegia ◽  
Ankle Foot Orthosis ◽  
Gait Parameters ◽  
Children With Cerebral Palsy ◽  
Foot Orthosis

Abstract Background: It has been reported the effects of a hinged ankle-foot orthosis on the gait ability of children with cerebral palsy. However, no studies investigated the effects of the dorsiflexion angle of the hinged ankle-foot orthosis on the spatiotemporal gait parameters of children with cerebral palsy. This study aimed to investigate the immediate effects of a 10° dorsiflexion inducing ankle-foot orthosis the spatiotemporal gait parameters of children with spastic diplegia compared to barefoot and a hinged ankle-foot orthosis.Methods: This study was cross-over design. 10 children with spastic diplegia were walked with barefoot, a hinged ankle-foot orthosis, and a 10° dorsiflexion inducing ankle-foot orthosis. GAITRite was used to collect the spatiotemporal gait parameters including gait velocity, cadence, step length, stride length, single leg support, and double leg support. Results: It showed that a 10° dorsiflexion inducing ankle-foot orthosis significantly improved the gait velocity, cadence, step length, stride length, single leg support, and double leg support than barefoot and a hinged ankle-foot orthosis (p<.05). Conclusion: The results of this study implied that a 10° dorsiflexion inducing ankle-foot orthosis could improve the gait ability of children with spastic diplegia more than barefoot or a hinged ankle-foot orthosis. High quality future studies will need to examine the effects of hinged ankle-foot orthosis on gait ability according to dorsiflexion angles.

A Soft Wearable Robotic Ankle-Foot-Orthosis for Post-Stroke Patients

2019 ◽  
Vol 4 (3) ◽  
pp. 2547-2552 ◽  
Author(s):  
Junghan Kwon ◽  
Ji-Hong Park ◽  
Subyeong Ku ◽  
YeongHyeon Jeong ◽  
Nam-Jong Paik ◽  
...  
Keyword(s):  
Stroke Patients ◽  
Ankle Foot Orthosis ◽  
Post Stroke ◽  
Foot Orthosis

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 The effect of changing plantarflexion resistive moment of an articulated ankle–foot orthosis on ankle and knee joint angles and moments while walking in patients post stroke

2015 ◽  
Vol 30 (8) ◽  
pp. 775-780 ◽  
Author(s):  
Toshiki Kobayashi ◽  
Madeline L. Singer ◽  
Michael S. Orendurff ◽  
Fan Gao ◽  
Wayne K. Daly ◽  
...  
Keyword(s):  
Knee Joint ◽  
Joint Angles ◽  
Ankle Foot Orthosis ◽  
Post Stroke ◽  
Foot Orthosis

scholarly journals Effects of plantar flexion resistive moment generated by an ankle-foot orthosis with an oil damper on the gait of stroke patients: a pilot study

2012 ◽  
Vol 37 (3) ◽  
pp. 212-221 ◽  
Author(s):  
Sumiko Yamamoto ◽  
Naoki Tomokiyo ◽  
Tadashi Yasui ◽  
Toshikazu Kawaguchi
Keyword(s):  
Plantar Flexion ◽  
Reaction Force ◽  
Three Dimensional ◽  
Chronic Phase ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Ankle Foot Orthosis ◽  
Paretic Limb ◽  
Gait Parameters ◽  
Foot Orthosis

Background: An ankle-foot orthosis with an oil damper was previously developed to assist the first rocker function during gait, but the effects of the amount of resistive moment generated on gait have not been clarified. Objectives: To measure the amount of resistive moment generated by the ankle-foot orthosis with an oil damper during gait and determine its effect on the gait of patients with stroke. Study Design: Preliminary cross-sectional study. Methods: The gait of four patients with stroke in the chronic phase was measured in four conditions: without an ankle-foot orthosis and with the ankle-foot orthosis with an oil damper generating three different amounts of resistive moment. Measurements were taken with a three-dimensional motion analysis system and a specially designed device to determine the resistive moment. Results: The resistive moment was observed in the former half in stance of the paretic limb, and its magnitude was less than 10 N m. Some gait parameters related to terminal stance and preswing were affected by the amount of resistive moment. The forward component of floor reaction force and the shank vertical angle showed peak values when the patients reported feeling most comfortable during gait. Conclusion: Although the resistive moment generated by the ankle-foot orthosis with an oil damper was small, it was sufficient to alter gait. Clinical relevance To maximize the effectiveness of ankle-foot orthoses, it is necessary to know the effects of resistive moment on the gait of patients with stroke. The ankle-foot orthosis with an oil damper assists the first rocker function in gait and also affects the gait in a later phase in stance. The peak values of some gait parameters coincided with patients reporting gait to be most comfortable. It is important to know that ankle-foot orthosis with an oil damper assistance in the first rocker alters the weight acceptance on the paretic limb and affects the gait parameters related to propulsion ability in stance.

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