Passive-dynamic ankle-foot orthoses substitute for ankle strength while causing adaptive gait strategies: a feasibility study.

Abstract:

:Bending stiffness of passive-dynamic ankle-foot orthoses (PD-AFOs) is a functional characteristic thought to restore lost ankle function due to weakened plantar flexors. However, lower extremity impairment profiles of patients are seldom limited to plantar flexion weakness, and PD-AFO characteristics often influence gait in other ways. Combined, all PD-AFO characteristics and patient impairments likely mask the main effect of PD-AFO bending stiffness and complicate the PD-AFO bending stiffness prescription process. In this study, we propose a biomechanical probing paradigm, where customized PD-AFOs with a range of precise stiffness values are worn by healthy subjects, to experimentally test a PD-AFO strength substitution hypothesis while simultaneously documenting gait adaptations to PD-AFO use. Two healthy subjects walked at a scaled velocity while wearing a series of three PD-AFOs that ranged in bending stiffness levels. Supporting the strength substitution hypothesis, peak ankle plantar flexion moments remained unchanged across PD-AFO stiffness conditions. Further biomechanical analyses documented a complex series of ankle related kinematic and kinetic adaptive movement strategies due to PD-AFO use. This study demonstrated the utility of the biomechanical probing paradigm to help understand the contribution of PD-AFO stiffness to ankle strength and its secondary effects on ankle biomechanics.

journal_name

Ann Biomed Eng

authors

Arch ES,Stanhope SJ

doi

10.1007/s10439-014-1067-8

subject

Has Abstract

pub_date

2015-02-01 00:00:00

pages

442-50

issue

2

eissn

0090-6964

issn

1573-9686

journal_volume

43

pub_type

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