Stiffness-Optimized Ankle-Foot Orthoses Improve Walking Energy Cost Compared to Conventional Orthoses in Neuromuscular Disorders: A Prospective Uncontrolled Intervention Study
| Autor: | Frans Nollet, Jaap Harlaar, Fieke S. Koopman, Jasper J. den Boer, Viola C. Altmann, Merel-Anne Brehm, Niels F.J. Waterval |
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| Přispěvatelé: | AMS - Rehabilitation & Development, Rehabilitation medicine, Amsterdam Movement Sciences, Amsterdam Reproduction & Development (AR&D) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
030506 rehabilitation
medicine.medical_specialty Biomedical Engineering Foot Orthoses neuromuscular diseases Walking Electronic mail 03 medical and health sciences ankle foot orthosis 0302 clinical medicine Physical medicine and rehabilitation Internal Medicine medicine Humans Prospective Studies Gait business.industry General Neuroscience Rehabilitation Biomechanics Stiffness gait biomechanics Biomechanical Phenomena Plantar flexor weakness Preferred walking speed medicine.anatomical_structure Energy cost Ankle medicine.symptom 0305 other medical science business Gait biomechanics human activities 030217 neurology & neurosurgery |
| Zdroj: | IEEE Transactions on Neural Systems and Rehabilitation Engineering, 28(10):9174749, 2296-2304. Institute of Electrical and Electronics Engineers Inc. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 28(10) Waterval, N F J, Brehm, M A, Altmann, V C, Koopman, F S, Den Boer, J J, Harlaar, J & Nollet, F 2020, ' Stiffness-Optimized Ankle-Foot Orthoses Improve Walking Energy Cost Compared to Conventional Orthoses in Neuromuscular Disorders : A Prospective Uncontrolled Intervention Study ', IEEE Transactions on Neural Systems and Rehabilitation Engineering, vol. 28, no. 10, 9174749, pp. 2296-2304 . https://doi.org/10.1109/TNSRE.2020.3018786 IEEE transactions on neural systems and rehabilitation engineering, 28(10):9174749, 2296-2304. Institute of Electrical and Electronics Engineers Inc. |
| ISSN: | 1534-4320 |
| DOI: | 10.1109/TNSRE.2020.3018786 |
| Popis: | In persons with calf muscle weakness, walking energy cost is commonly increased due to persistent knee flexion and a diminished push-off. Provided ankle-foot orthoses (AFOs) usually lower walking energy cost. To maximize the reduction in energy cost, AFO bending stiffness should be individually optimized, but this is not common practice. Therefore, we aimed to evaluate whether individually stiffness-optimized AFOs reduce walking energy cost compared to conventional AFOs in persons with non-spastic calf muscle weakness and, secondarily, whether stiffness-optimized AFOs improve walking speed and gait biomechanics. Thirty-seven persons with non-spastic calf muscle weakness using a conventional AFO were included. Participants were provided a new, individually stiffness-optimized AFO. Walking energy cost, speed and gait biomechanics were assessed, at delivery and 3-months follow-up. Stiffness-optimized AFOs reduced walking energy cost with 9.2% (-0.42J/kg/m, 95%CI: 0.26 to 0.57) compared to the conventional AFOs while walking speed increased with 5.2% (+0.05m/s, 95%CI: 0.03 to 0.08). In bilateral affected persons the effects were larger compared to unilateral affected persons (difference effect energy cost: 0.31J/kg/m, speed: +0.09m/s). Although individually gait biomechanics changed considerably, no significant group differences were found (p > 0.118). We demonstrated that individually stiffness-optimized AFOs considerably and meaningfully reduced walking energy cost compared to conventional AFOs, which was accompanied by an increase in walking speed. Especially in bilateral affected persons large effects of stiffness-optimization were found. The individual differences in gait changes substantiate the recommendation that the AFO bending stiffness should be individually tuned to minimize walking energy cost. |
| Databáze: | OpenAIRE |
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