Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium.
Centre of Expertise Care and Well-Being, Research Group Mobilab & Care, Thomas More University of Applied Sciences, Campus Geel, 2440 Geel, Belgium.
Sensors (Basel). 2024 Oct 11;24(20):6562. doi: 10.3390/s24206562.
Ankle-foot orthoses (AFOs) are commonly prescribed to children with cerebral palsy (CP). The conventional AFO successfully controls the first and second ankle rocker, but it fails to correct the third ankle rocker, which negatively effects push-off power. The current study evaluated a new powered AFO (PAFO) design, developed to address the shortcomings of the conventional AFO. Eight children with spastic CP (12.4 ± 3.4 years; GMFCS I-III; 4/4-♂/♀; 3/5-bi/unilateral) were included. Sagittal kinematic and kinetic data were collected from 20 steps during barefoot walking, with conventional AFOs and PAFOs. In the PAFO-condition, an actuation unit was attached to a hinged AFO and through push-pull cables to a backpack that was carried by the child and provided patient-specific assistance-as-needed. SnPM-analysis indicated gait cycle sections that differed significantly between conditions. For the total group, differences between the three conditions were found in ankle kinematics (49.6-66.1%, = 0.006; 88.0-100%, = 0.011) and angular velocity (0.0-6.0%, = 0.001; 45.1-51.1%, = 0.006; 62.2-73.0%, = 0.001; 81.2-93.0%, = 0.001). Individual SnPM-analysis revealed a greater number of significant gait cycle sections for kinematics and kinetics of the ankle, knee, and hip. These individual results were heterogeneous and specific per gait pattern. In conclusion, the new PAFO improved the ankle range-of-motion, angular velocity, and power during push-off in comparison to the conventional AFO.
踝足矫形器（AFO）常用于治疗脑瘫（CP）患儿。传统的 AFO 成功控制了第一和第二踝关节跖屈，但无法纠正第三踝关节跖屈，从而降低了蹬离力量。本研究评估了一种新的动力式踝足矫形器（PAFO）设计，旨在解决传统 AFO 的缺点。纳入 8 例痉挛型 CP 患儿（12.4±3.4 岁；GMFCS I-III；4/4-♂/♀；3/5-双侧）。在裸足行走时，使用传统 AFO 和 PAFO 收集 20 步的矢状面运动学和动力学数据。在 PAFO 状态下，一个致动单元连接到一个铰链 AFO，并通过推拉电缆连接到一个背包，由儿童携带，根据需要提供特定于患者的辅助。SnPM 分析表明，不同条件下的步态周期节段存在显著差异。对于整个组，在踝关节运动学（49.6-66.1%， = 0.006；88.0-100%， = 0.011）和角速度（0.0-6.0%， = 0.001；45.1-51.1%， = 0.006；62.2-73.0%， = 0.001；81.2-93.0%， = 0.001）方面，三种条件之间存在差异。个别 SnPM 分析显示，踝关节、膝关节和髋关节的运动学和动力学有更多显著的步态周期节段。这些个体结果具有异质性，且具有特定的步态模式特异性。总之，与传统 AFO 相比，新的 PAFO 改善了踝关节的活动范围、角速度和蹬离时的功率。
