DoD-VA Extremity Trauma and Amputation Center of Excellence, San Antonio, TX, USA.
Center for Limb Loss and Mobility, VA Puget Sound, Seattle, WA, USA.
Prosthet Orthot Int. 2021 Apr 1;45(2):147-152. doi: 10.1177/0309364620971407.
Maintaining an optimal rolling of the foot over the ground is thought to increase the stability and efficiency of pathologic gait. Ankle-foot orthoses are often prescribed to improve gait mechanics in individuals with lower extremity injuries; however, their design may compromise how the foot rolls over the ground.
The aim of this study was to investigate the effects of the sagittal plane ankle-foot orthosis alignment on roll-over shape and center of pressure velocity in individuals with lower limb reconstructions.
Randomized cross-over study with a control group comparison.
In total, 12 individuals with lower limb reconstruction who used a custom carbon ankle-foot orthosis and 12 uninjured controls underwent gait analysis. Ankle-foot orthosis users were tested in their clinically-provided ankle-foot orthosis alignment, with an alignment that was 3° more plantarflexed, and with an alignment that was 3° more dorsiflexed. Components of roll-over shape and center of pressure velocity were calculated from heel strike on the ankle-foot orthosis limb to contralateral heel strike.
Roll-over shape radius was not affected by 3° changes to alignment and was not significantly different from controls. Aligning the ankle-foot orthosis in more dorsiflexion than clinically provided resulted in a smaller peak center of pressure velocity that occurred later in stance.
Individuals using custom carbon ankle-foot orthoses can accommodate 3° alterations in the dorsiflexion or plantarflexion alignment.
人们认为，保持足部在地面上的最佳滚动状态可以提高病理性步态的稳定性和效率。踝足矫形器常用于改善下肢损伤患者的步态力学，但它们的设计可能会影响足部在地面上的滚动方式。
本研究旨在探讨踝足矫形器矢状面对线对下肢重建患者足部滚动形状和压力中心速度的影响。
随机交叉研究与对照组比较。
共有 12 名使用定制碳纤维踝足矫形器的下肢重建患者和 12 名未受伤的对照组进行了步态分析。踝足矫形器使用者在其临床提供的踝足矫形器对线、3°跖屈对线和 3°背屈对线三种情况下接受测试。从踝足矫形器肢体的足跟触地到对侧足跟触地，计算滚动形状和压力中心速度的各个组成部分。
3°对线变化对滚动形状半径没有影响，且与对照组无显著差异。与临床提供的踝足矫形器对线相比，背屈对线更有利于形成较小的峰值压力中心速度，且该峰值速度出现在支撑相的后期。
使用定制碳纤维踝足矫形器的患者可以适应背屈或跖屈对线 3°的变化。
