Yokoyama Osamu, Sashika Hironobu, Hagiwara Akiyoshi, Yamamoto Sumiko, Yasui Tadashi
Department of Rehabilitation Medicine, Kanagawa Rehabilitation Center, Kanagawa, Japan.
Arch Phys Med Rehabil. 2005 Jan;86(1):162-6. doi: 10.1016/j.apmr.2003.11.026.
The ankle joint of ankle-foot orthoses (AFOs) should restrict plantarflexion to prevent foot drop during the swing phase. However, excessive plantarflexion resistance causes excessive knee flexion during the stance phase. Plantarflexion resistive moment should be easily adjustable according to the gait ability of patients with hemiplegia. Because it is difficult to adjust plantarflexion resistive moment exactly, we developed an AFO with an oil damper. It is a small shock absorber that utilizes hydraulic resistance. The oil damper generates a resistive moment to the plantarflexion rotation of the ankle joint at the initial stance phase. The magnitude of the plantarflexion resistive moment at the heel strike can be easily adjusted to accommodate each patient's condition by simply turning an adjustment screw. We used a gait analysis system to compare the gait of 2 hemiplegic patients while they were wearing either the AFO with the oil damper or the AFO with the plantarflexion stop. The AFO with the oil damper achieved sufficient plantarflexion of the ankle and mild flexion of the knee by adjusting a proper plantarflexion resistive moment during initial stance phase, and provided a more comfortable gait than did the AFOs with a plantarflexion stop.
踝足矫形器(AFO)的踝关节应限制跖屈,以防止摆动期出现足下垂。然而,过大的跖屈阻力会导致站立期膝关节过度屈曲。跖屈阻力矩应根据偏瘫患者的步态能力进行轻松调节。由于精确调节跖屈阻力矩较为困难,我们开发了一种带有油阻尼器的AFO。它是一种利用液压阻力的小型减震器。油阻尼器在初始站立期对踝关节的跖屈旋转产生阻力矩。通过简单地转动调节螺钉,足跟触地时的跖屈阻力矩大小可以轻松调节,以适应每个患者的情况。我们使用步态分析系统比较了2名偏瘫患者分别穿着带有油阻尼器的AFO和带有跖屈限位器的AFO时的步态。带有油阻尼器的AFO通过在初始站立期调节适当的跖屈阻力矩,实现了踝关节足够的跖屈和膝关节的轻度屈曲,并且比带有跖屈限位器的AFO提供了更舒适的步态。