Kobayashi Toshiki, Orendurff Michael S, Singer Madeline L, Daly Wayne K, Lincoln Lucas S, Gao Fan, Foreman K Bo
Orthocare Innovations, Mountlake Terrace, USA.
Department of Prosthetics and Orthotics, Faculty of Health Sciences, Hokkaido University of Science, Sapporo, Japan.
J Rehabil Assist Technol Eng. 2016 Mar 31;3:2055668316639445. doi: 10.1177/2055668316639445. eCollection 2016 Jan-Dec.
The plantarflexion resistive moments of an articulated ankle-foot orthosis play an important role in improving gait in individuals post stroke. However, the evidence regarding their magnitude required from the articulated ankle-foot orthosis to improve walking is still limited. Therefore, the primary aim of this study was to directly measure the plantarflexion resistive moments and the joint angular positions while walking using a prototype instrumented articulated ankle-foot orthosis in five individuals post stroke. The secondary aim was to investigate their moment-angle relationship by changing its preset plantarflexion stiffness. Each subject was fitted with the instrumented articulated ankle-foot orthosis and walked on a treadmill under four different preset plantarflexion stiffness conditions (0.35 N·m/°, 0.51 N·m/°, 0.87 N·m/°, and 1.27 N·m/°). For each subject, the plantarflexion resistive moments and the joint angular positions of five continuous gait cycles were extracted and averaged for each condition. Data were plotted and presented as case series. Both plantarflexion resistive moments and joint angular positions of the ankle-foot orthosis changed according to the preset plantarflexion stiffness in all subjects. Using the instrumented articulated ankle-foot orthosis could potentially advance the understanding of the biomechanics of an ankle-foot orthosis, as well as contribute to more evidence-based orthotic care of patients.
关节式踝足矫形器的跖屈阻力矩在改善中风后个体的步态方面起着重要作用。然而,关于关节式踝足矫形器改善步行所需的阻力矩大小的证据仍然有限。因此,本研究的主要目的是使用原型仪器化关节式踝足矫形器,直接测量五名中风后个体行走时的跖屈阻力矩和关节角位置。次要目的是通过改变其预设的跖屈刚度来研究它们的力矩-角度关系。每位受试者均佩戴仪器化关节式踝足矫形器,并在四种不同的预设跖屈刚度条件(0.35 N·m/°、0.51 N·m/°、0.87 N·m/°和1.27 N·m/°)下在跑步机上行走。对于每位受试者,提取五个连续步态周期的跖屈阻力矩和关节角位置,并对每种条件进行平均。数据绘制并以病例系列形式呈现。在所有受试者中,踝足矫形器的跖屈阻力矩和关节角位置均根据预设的跖屈刚度而变化。使用仪器化关节式踝足矫形器可能会增进对踝足矫形器生物力学的理解,并有助于为患者提供更多基于证据的矫形护理。