Bennett Bradford C, Russell Shawn D, Abel Mark F
Department of Orthopaedic Surgery, Motion Analysis and Motor Performance Laboratory, University of Virginia, 2270 Ivy Rd., Charlottesville, VA 22903, USA.
Clin Biomech (Bristol). 2012 Mar;27(3):287-91. doi: 10.1016/j.clinbiomech.2011.09.005. Epub 2011 Oct 20.
Studies suggest that 50% of children with cerebral palsy are prescribed ankle foot orthoses. One of the aims of ankle foot orthosis use is to aid in walking. This research examined the effects that ankle foot orthoses have on the energy recovery and the mechanical work performed by children with cerebral palsy during walking.
Twenty-one children with spastic diplegia walked with and without their prescribed bilateral ankle foot orthoses. Ten of the subjects wore articulated (hinged) orthoses and 11 subjects wore solid orthoses. Three dimensional kinematic data were collected and between and within group repeated measures ANOVAs were applied to the dependent measures.
The results were similar for both groups. There was an increase in stride length, energy recovery, and potential energy and the kinetic energy variation. There was no change in the mechanical work performed to walk or the normalized center of mass vertical excursion. Unfortunately, the increase in energy recovery did not alter the external work, as it was offset by increased variation in the potential and kinetic energies of the center of mass. There was a great deal of variability in the measured work, with both large increases and decreases in the work of individual subjects when wearing orthoses.
These results suggest that current ankle foot orthoses can reduce the work to walk, but do not do so for many children with cerebral palsy. This research suggests that ankle foot orthosis prescription could be aided by measuring the mechanical work during walking.
研究表明，50%的脑瘫患儿会使用踝足矫形器。使用踝足矫形器的目的之一是辅助行走。本研究调查了踝足矫形器对脑瘫患儿行走过程中能量恢复及所做机械功的影响。
21名痉挛型双侧瘫患儿分别在佩戴和不佩戴其指定的双侧踝足矫形器的情况下行走。其中10名受试者佩戴有关节（铰链式）矫形器，11名受试者佩戴固态矫形器。收集三维运动学数据，并将组间和组内重复测量方差分析应用于相关测量指标。
两组结果相似。步长、能量恢复、势能及动能变化均有所增加。行走所做的机械功或质心垂直偏移标准化值没有变化。遗憾的是，能量恢复的增加并未改变外部功，因为它被质心势能和动能变化的增加所抵消。测量的功存在很大变异性，佩戴矫形器时个别受试者的功既有大幅增加也有大幅减少。
这些结果表明，目前的踝足矫形器可以减少行走的功，但对许多脑瘫患儿却并非如此。本研究表明，通过测量行走过程中的机械功，有助于踝足矫形器的处方制定。
