Liu Wei, Wu Hui-Dong, Li Yu-Ying, Zhu Ringo Tang-Long, Luo Yu-Yan, Ling Yan To, Wang Li-Ke, Wang Jian-Fa, Zheng Yong-Ping, Ma Christina Zong-Hao
Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Department of Prosthetic and Orthotic Engineering, School of Rehabilitation, Kunming Medical University, Kunming 650500, China.
Biosensors (Basel). 2024 Dec 4;14(12):595. doi: 10.3390/bios14120595.
Ankle-foot orthoses (AFOs) have been commonly prescribed for stroke survivors with foot drop, but their impact on the contractions of paretic tibialis anterior (TA) and medial gastrocnemius (MG) has remained inconclusive. This study thus investigated the effect of AFOs on these muscle contractions in stroke survivors. The contractions of paretic TA and MG muscles were assessed in twenty stroke patients and compared between walking with and without AFOs, using a novel wearable dynamic ultrasound imaging and sensing system. The study found an increase in TA muscle thickness throughout a gait cycle ( > 0.05) and a significant increase in TA muscle surface mechanomyography (sMMG) signals during the pre- and initial swing phases ( < 0.05) when using an AFO. MG muscle thickness generally decreased with the AFO ( > 0.05), aligning more closely with trends seen in healthy adults. The MG surface electromyography (sEMG) signal significantly decreased during the initial and mid-swing phases when wearing an AFO ( < 0.05). The TA-MG co-contraction index significantly decreased during initial and mid-swing phases with the AFO ( < 0.05). These results suggest that AFOs positively influenced the contraction patterns of paretic ankle muscles during walking in stroke patients, but further research is needed to understand their long-term effects.
踝足矫形器（AFO）常用于为足下垂的中风幸存者开具处方，但它们对患侧胫骨前肌（TA）和腓肠肌内侧头（MG）收缩的影响仍无定论。因此，本研究调查了AFO对中风幸存者这些肌肉收缩的影响。使用一种新型可穿戴动态超声成像和传感系统，对20名中风患者患侧TA和MG肌肉的收缩情况进行了评估，并比较了佩戴AFO行走和不佩戴AFO行走时的情况。研究发现，使用AFO时，整个步态周期中TA肌肉厚度增加（>0.05），在摆动前期和初始摆动期TA肌肉表面机械肌电图（sMMG）信号显著增加（<0.05）。佩戴AFO时，MG肌肉厚度一般会降低（>0.05），与健康成年人的趋势更为接近。佩戴AFO时，MG表面肌电图（sEMG）信号在初始摆动期和摆动中期显著降低（<0.05）。使用AFO时，TA-MG共同收缩指数在初始摆动期和摆动中期显著降低（<0.05）。这些结果表明，AFO对中风患者行走过程中患侧踝关节肌肉的收缩模式有积极影响，但需要进一步研究以了解其长期影响。
