Comparison of five different methodologies for evaluating ankle-foot orthosis stiffness.

Autor: Shuman BR; Center for Limb Loss and Mobility, VA Puget Sound, 1660 S Columbian Way, Seattle, WA, USA. bshuman@hjf.org.; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA. bshuman@hjf.org., Totah D; Department of Mechanical Engineering, University of Iowa, Iowa City, IA, USA., Gates DH; School of Kinesiology, University of Michigan, Ann Arbor, MI, USA., Gao F; Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA., Ries AJ; James R. Gage Center for Gait & Motion Analysis, Gillette Children's Specialty Healthcare, St. Paul, MN, USA., Russell Esposito E; Center for Limb Loss and Mobility, VA Puget Sound, 1660 S Columbian Way, Seattle, WA, USA.; DOD-VA Extremity Trauma and Amputation Center of Excellence (EACE), Joint Base San Antonio Fort Sam Houston, TX, USA.
Jazyk: angličtina
Zdroj: Journal of neuroengineering and rehabilitation [J Neuroeng Rehabil] 2023 Jan 22; Vol. 20 (1), pp. 11. Date of Electronic Publication: 2023 Jan 22.
DOI: 10.1186/s12984-023-01126-7
Abstrakt: Background: The mechanical properties of an ankle-foot orthosis (AFO) play an important role in the gait mechanics of the end user. However, testing methodologies for evaluating these mechanical properties are not standardized. The purpose of this study was to compare five different evaluation frameworks to assess AFO stiffness.
Method: The same 13 carbon composite AFOs were tested with five different methods. Four previously reported custom test fixtures (the BRUCE, KST, SMApp, and EMPIRE) rotated an AFO into dorsiflexion about a defined axis in the sagittal plane. The fifth method involved quasi-static deflection of AFOs into dorsiflexion by hanging weights (HW) from the footplate. AFO rotational stiffness was calculated as the linear fit of the AFO resistive torque and angular deflection. Differences between methods were assessed using descriptive statistics and a repeated measures Friedman with post-hoc Bonferroni-Holm adjusted Wilcoxon signed-rank tests.
Results: There were significant differences in measured AFO stiffnesses between test methods. Specifically, the BRUCE and HW methods measured lower stiffness than both the EMPIRE and the KST. Stiffnesses measured by the SMApp were not significantly different than any test method. Stiffnesses were lowest in the HW method, where motion was not constrained to a single plane. The median difference in absolute AFO stiffness across methods was 1.03 Nm/deg with a range of [0.40 to 2.35] Nm/deg. The median relative percent difference, measured as the range of measured stiffness from the five methods over the average measured stiffness was 62% [range 13% to 156%]. When the HW method was excluded, the four previously reported test fixtures produced a median difference in absolute AFO stiffness of 0.52 [range 0.38 to 2.17] Nm/deg with a relative percent difference between the methods of 27% [range 13% to 89%].
Conclusions: This study demonstrates the importance of developing mechanical testing standards, similar to those that exist for lower limb prosthetics. Lacking standardization, differences in methodology can result in large differences in measured stiffness, particularly for different constraints on motion. Non-uniform measurement practices may limit the clinical utility of AFO stiffness as a metric in AFO prescription and future research.
(© 2023. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje