Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
Clin Biomech (Bristol). 2024 Jul;117:106284. doi: 10.1016/j.clinbiomech.2024.106284. Epub 2024 Jun 4.
Carbon-fiber custom dynamic orthoses are used to improve gait and limb function following lower limb trauma in specialty centers. However, the effects of commercially available orthoses on center of pressure progression and patient perception of orthosis smoothness during walking are poorly understood.
In total, 16 participants with a unilateral lower extremity traumatic injury underwent gait analysis when walking without an orthosis, and while wearing monolithic and modular devices, in a randomized order. Device alignment, stiffness, participant rating of perceived device smoothness, center of pressure velocity, and ankle zero moment crossing were assessed.
The modular device was approximately twice as stiff as the monolithic device. Alignment, smoothness ratings, peak magnitude of center of pressure velocity, and zero moment crossing were not different between study devices. The time to peak center of pressure velocity occurred significantly later for the modular device compared to the monolithic and no orthosis conditions, with large effect sizes observed.
Commercially available orthoses commonly used to treat limb trauma affect the timing of center of pressure progression relative to walking without an orthosis. Despite multiple design differences, monolithic and modular orthoses included in this study did not differ with respect to other measures of center of pressure progression. Perceived smoothness ratings were approximately 40% greater with the study orthoses as compared to previous studies in specialty centers, which may be due to a more gradual center of pressure progression, as indicted by lower peak magnitude of center of pressure velocity with both study orthoses.
碳纤维定制动态矫形器用于改善下肢创伤后专科中心的步态和肢体功能。然而，市售矫形器对压力中心进展的影响以及患者对行走时矫形器平滑度的感知仍知之甚少。
共有 16 名单侧下肢创伤患者在不佩戴矫形器、佩戴整体式和模块式设备的情况下，按随机顺序进行步态分析。评估设备的对准、刚度、患者对设备平滑度的感知评分、压力中心速度和踝关节零力矩交叉。
模块式设备的刚度约为整体式设备的两倍。研究设备之间的对准、平滑度评分、压力中心速度峰值大小和零力矩交叉没有差异。与整体式和无矫形器状态相比，模块式设备的压力中心速度峰值出现的时间明显延迟，观察到较大的效应量。
常用于治疗肢体创伤的市售矫形器会影响压力中心相对于无矫形器行走时的进展时间。尽管存在多种设计差异，但本研究中包含的整体式和模块式矫形器在压力中心进展的其他测量方面没有差异。与专科中心之前的研究相比，研究用矫形器的平滑度感知评分大约高出 40%，这可能是由于压力中心进展更缓慢，两个研究用矫形器的压力中心速度峰值幅度较低所致。
