Plastic Ankle Foot Orthosis Research Articles

Diverse Plantarflexor Module Characteristics Influence Immediate Effects of Plastic Ankle-Foot Orthosis on Gait Performance in Patients With Stroke: A Cross-sectional Study

ObjectiveTo investigate the immediate effects of plastic ankle-foot orthosis (AFO) on locomotor performance in patients with stroke and determine how such effects might undergo alteration when distinct plantarflexor (PF) module subtypes are considered. DesignCross-sectional study. SettingTwo university hospitals. ParticipantsFifty-two patients with stroke and 21 of those without stroke (N=73). InterventionsNot applicable. Main Outcome MeasuresMotor modules were identified through non-negative matrix factorization, and participants were classified into 3 groups: independent-normal-timing, independent-altered-timing, and merged PF modules. To assess the effects of the AFO, gait measurements reflecting locomotor performance were obtained with and without the presence of the plastic AFO for each group. ResultsThe independent-altered-timing group had increased paretic propulsion, greater non-paretic step length, and faster walking speed after the administration of the plastic AFO; however, these significant changes were not observed in the independent-normal-timing and merged PF module groups. Notably, patients in the independent-normal-timing and merged PF module groups exhibited longer paretic stance times. ConclusionThis study suggests that the immediate effects of plastic AFO depend on the PF module subtype. These findings can potentially guide clinical decision-making regarding AFO selection for stroke rehabilitation in patients with diverse gait control characteristics.

Commonly Used Types and Recent Development of Ankle-Foot Orthosis: A Narrative Review.

(1) Background: ankle-foot orthosis (AFO) is the most commonly prescribed orthosis to patients with foot drop, and ankle and foot problems. In this study, we aimed to review the commonly used types of AFO and introduce the recent development of AFO. (2) Methods: narrative review. (3) Results: AFO prevents the foot from being dragged, provides a clearance between the foot and the ground in the swinging phase of gait, and maintains a stable posture by allowing heel contact with the ground during the stance phase. In clinical practice, the most commonly used AFO include plastic AFO, walking boot, UD-Flex, and carbon fiber AFO. In addition, for compensating the demerits of these conventional AFOs, new types of AFOs, including AF Servo, TurboMed, three-dimensionally printed AFO, and AFO made from kenaf composites, were developed. (4) Conclusions: we think that our review can guide clinicians in selecting and prescribing the appropriate AFO for each patient in accordance with their specific physical conditions.

Study on the method of fabricating plastic ankle foot orthosis (PAFO) from 3D foot shape

Study on the method of fabricating plastic ankle foot orthosis (PAFO) from 3D foot shape

Load and Deformation on a Plastic Ankle-Foot Orthosis during Walking

Load and Deformation on a Plastic Ankle-Foot Orthosis during Walking

Study on the design development of a multi joint ankle foot orthosis.

[Purpose] The purpose of this study was to investigate the effects of a newly designed multi joint ankle-foot orthosis on the gait and dynamic balance of stroke patients having foot drop. [Participants and Methods] This study was investigated 10 participants who were diagnosed with stroke. Patients were evaluated based on a 10-meter walk test, timed up and go test and Berg balance scale after each participant wore a plastic ankle-foot orthosis and a multi joint ankle-foot orthosis (AFO) that consisted of orthosis joints (having poster-stop joint and Klenzak joint functions). [Results] The 10-meter walk test, timed up and go test and Berg balance scale showed significant differences in the orthosis with the Klenzak joint function. [Conclusion] The appropriate use of Klenzak AFO of the newly designed multi joint AFO is expected to have a positive effect on improving the gait and balancing ability of stroke patients having foot drop.

The effect of newly designed multi joint ankle foot orthosis on the gait and dynamic balance of stroke patients with foot drop.

[Purpose] The purpose of this study is to investigate the effect of the newly designed multi joint ankle-foot orthosis on the gait and dynamic balance of stroke patients having foot drop. [Subjects and Methods] This study was conducted with 15 subjects who were diagnosed with stroke. 10-meter walk test, functional reaching test and timed up and go test were measured after each subjects wore a plastic ankle-foot orthosis and a multi joint ankle-foot orthosis that consists of orthosis joints (having free joint, anterior-stop joint, poster-stop joint, and Klenzak joint functions). In the case of the newly developed multi joint ankle-foot orthosis, the experiments were performed using posterior-stop joint and Klenzak joint. [Results] 10-meter walk test, functional reaching test and timed up and go test showed significant differences in the orthosis using posterior joint-stop function and Klenzak joint function. [Conclusion] The appropriate use of the four functions of the newly designed multi joint ankle-foot orthosis is expected to have a positive effect on improving the gait and balancing ability of stroke patients having foot drop.

The effect of newly designed multi joint ankle foot orthosis on the gait and dynamic balance of stroke patients with foot drop.

[Purpose] The purpose of this study is to investigate the effect of the newly designed multi joint ankle-foot orthosis on the gait and dynamic balance of stroke patients having foot drop. [Subjects and Methods] This study was conducted with 15 subjects who were diagnosed with stroke. 10-meter walk test, functional reaching test and timed up and go test were measured after each subjects wore a plastic ankle-foot orthosis and a multi joint ankle-foot orthosis that consists of orthosis joints (having free joint, anterior-stop joint, poster-stop joint, and Klenzak joint functions). In the case of the newly developed multi joint ankle-foot orthosis, the experiments were performed using posterior-stop joint and Klenzak joint. [Results] 10-meter walk test, functional reaching test and timed up and go test showed significant differences in the orthosis using posterior joint-stop function and Klenzak joint function. [Conclusion] The appropriate use of the four functions of the newly designed multi joint ankle-foot orthosis is expected to have a positive effect on improving the gait and balancing ability of stroke patients having foot drop.

プラスチック短下肢装具の加工修正に伴う力学的特性評価

We research about fabrication and modification of Plastic Ankle-Foot Orthosis (PAFO) which usually prescribed for reducing the aftereffects of the stroke patients. We firstly got a 3D model using a 3D scanner and performed a Finite-Element Analysis (FEA) to the model. Secondly, we got the model with both sides trimming and performed FEA to it. In addition, I compared the shoe horn brace with the Texas shoe horn which was able to get by transforming the same brace. As a result, I found that the Texas Shoe horn had a bigger quantity of displacement than the ordinary shoe horn.

Effectiveness of elastic band-type ankle-foot orthoses on postural control in poststroke elderly patients as determined using combined measurement of the stability index and body weight-bearing ratio.

PurposePoor recovery of postural stability poststroke is the primary cause of impairment in activities and social participation in elderly stroke survivors. The purpose of our study was to experimentally evaluate the effectiveness of our new elastic ankle–foot orthosis (AFO), compared to a traditional AFO fabricated with hard plastic, in improving postural stability in elderly chronic stroke survivors.Patients and methodsPostural stability was evaluated in ten chronic stroke patients, 55.7±8.43 years old. Postural stability was evaluated using the standardized methods of the Biodex Balance System combined with a foot pressure system, under three experimental conditions, no AFO, rigid plastic AFO, and elastic AFO (E-AFO). The following dependent variables of postural stability were analyzed: plantar pressure under the paretic and nonparetic foot, area of the center of balance (COB) and % time spent in each location, distance traveled by the COB away from the body center, distance traveled by the center of pressure, and calculated index of overall stability, as well as indices anterior–posterior and medial–lateral stability.ResultsBoth AFO designs improved all indices of postural stability. Compared to the rigid plastic AFO, the E-AFO produced additional positive effects in controlling anterior–posterior body sway, equalizing weight bearing through the paretic and nonparetic limbs, and restraining the displacement of the center of pressure and of the COB.ConclusionBased on our outcomes, we recommend the prescription of E-AFOs as part of a physiotherapy rehabilitation program to promote recovery of postural stability poststroke. When possible, therapeutic outcomes should be documented using the Biodex Balance System and foot pressure system, as used in our study, to provide evidence needed to support the development of a larger controlled trial to generate high-quality evidence on the effectiveness of E-AFOs.

片麻痺患者におけるプラスチック製短下肢装具の役割

片麻痺患者におけるプラスチック製短下肢装具の役割

Effect of a Hybrid Ankle Foot Orthosis Made of Polypropylene and Fabric in Chronic Hemiparetic Stroke Patients

The ankle foot orthosis (AFO) has been used for control of ankle motion in stroke patients for a long time. However, studies on the materials used in construction of AFOs have been limited. In this study, the authors attempted to investigate the effect of a hybrid AFO made with polypropylene and fabric in comparison with a conventional plastic AFO in terms of convenience and effect in patients with chronic hemiparetic stroke. Seventeen patients with chronic hemiparetic stroke who have used plastic AFOs were recruited for this study. Two types of AFOs were used: plastic AFO made with polypropylene and hybrid AFO made with polypropylene covered with canvas fabric, which were individually molded and fitted. Convenience was evaluated using a self-developed questionnaire on patients' satisfaction and weights of AFO, and effect was evaluated using gait analysis. On the satisfaction questionnaire, satisfaction was greater for the hybrid AFO, and it was lighter in weight than the plastic AFO (P < 0.05). In gait analysis, faster walking speed, larger mean and peak ankle dorsiflexion angles, and ankle dorsiflexion angles at heel strike and toe off were observed for the hybrid and plastic AFOs compared with barefoot (P < 0.05). No significant difference was observed between the two orthoses, except for ankle dorsiflexion angle at heel strike, in which the plastic AFO showed higher ankle dorsiflexion angle than did the hybrid AFO. According to the results of this study, the hybrid AFO showed a similar effect in function, except for ankle dorsiflexion angle at heel strike, and was superior with regard to convenience compared with the conventional plastic AFO in chronic hemiparetic stroke patients. Therefore, it seems that, in general, the hybrid AFO can be recommended for hemiparetic stroke patients who require an AFO.

Kinematic Analysis of Plastic Ankle-Foot Orthosis Using Force Sensors

Kinematic Analysis of Plastic Ankle-Foot Orthosis Using Force Sensors

Improving the Comfort of Wearable Equipment for the Disabled Part 2 : Thermoregulation and Climate inside Clothing When Wearing a Plastic Ankle-Foot Orthosis (AFO)

Improving the Comfort of Wearable Equipment for the Disabled Part 2 : Thermoregulation and Climate inside Clothing When Wearing a Plastic Ankle-Foot Orthosis (AFO)

*Poster 171: Evaluation of Forefoot Force During Terminal Double Support With Ankle Foot Orthosis

Objective: To objectively evaluate forefoot mean force during terminal double support (TDS) in individuals with hemiplegia with and without an ankle foot orthosis (AFO). Design: A prospective study. Setting: Rehabilitation research center. Participants: 15 adults with stroke related hemiplegia more than 6 months, currently using a rigid plastic AFO. Interventions: Not applicable. Main Outcome Measures: Whole foot mean force (N) and forefoot (metatarsal heads, toes, and hallux) mean force (N) during the terminal double support (TDS) phase of the gait cycle.

The Recovery of Running Ability in an Adolescent Male After Traumatic Brain Injury: A Case Study

The purpose of this case study was to document outcomes after a rehabilitation program in an adolescent male after traumatic brain injury. Three years after sustaining an injury in a skiing accident, a 17-year-old boy participated in a rehabilitation program with the goal of acquiring the ability to run one mile with his peers. On initial evaluation, the individual had significant left lower extremity weakness, impaired standing balance, limited endurance, and running limitations. He was able to run 10 m wearing a plastic ankle-foot orthosis on the left side but required supervision for safety. The intervention included strength training once weekly for 17 weeks, body weight-supported, treadmill-based locomotor training once weekly for 15 weeks followed by a combination of overground locomotor training and strengthening exercise once weekly for six weeks. After the intervention, muscle strength of the lower extremities increased and the individual was able to run one mile independently. The quality of his running improved, with better mechanics to absorb forces at impact during the absorption phase and increased lower extremity extension during the propulsion phase. A rehabilitation program consisting of strengthening and locomotor training improved running speed, quality, and endurance in an adolescent male after traumatic brain injury. He was able to progress to a less restrictive carbon fiber brace as a result of gains in lower extremity strength. This change in ability allowed him to participate in physical education by running on a track and playing softball with his peers.

Improving Gait Stability in Stroke Hemiplegic Patients with a Plastic Ankle-Foot Orthosis

Stroke is the leading cause of long-term disability, and many stroke patients have hemiparesis. Hemiparesis induces ankle-control disturbances and equinovarus deformity, leading to difficulty in walking and an increased risk for falling. Plastic ankle-foot orthosis (PAFO) is frequently prescribed to correct ankle joint alignment and increase walking speed and stride length during ambulation. While several studies have shown that PAFO improves gait parameters, such as stride length and walking speed, in hemiplegic patients, the effect of PAFO on gait stability remains unclear. We quantitatively assessed the effect of PAFO on gait stability in 16 hemiplegic stroke patients (mean age 55.9 +/- 11.8 years; 5 female and 11 male subjects; and 11 hemorrhagic and 5 ischemic stroke) using an ink footprint record. Wearing PAFO significantly improved the stride length, step length on the unaffected and affected sides, step width, walking speed, step frequency and functional ambulation ability. The coefficient of variation (CV), as an index of stability of movement from trial to trial, provides a measure that defines motor skills for a given task. Unaffected-side step-length CV and step-width CV were significantly decreased, when using PAFO. Furthermore, the correlation was found only between unaffected-side step length and its CV. The decrease in CV indicates that PAFO improved gait stability. We concluded that in addition to providing a faster gait, PAFO improves gait stability during walking. Gait stability and gait efficiency need to be considered separately in evaluating the effects of ankle-foot orthosis on gait performance in hemiplegic patients.

歩行障害の悪化が契機となり遺伝子解析によりＸ連鎖性シャルコー・マリー・トゥース病と診断された末梢神経障害の１症例

We report a 59-year-old man with X-linked Charcot-Marie-Tooth disease. Although the patient had already been diagnosed with polyneuropathy at a hospital, he was admitted to our department for further rehabilitative treatments because he began to notice that he needed assistance while walking. On admission, he had muscle atrophy and weakness in the distal part of his extremities, sensory loss of touch and pain in the fingers, feet and toes, and loss of deep tendon reflexes, and pes equino-cavus. Conduction velocities of the bilateral median, ulnar, and tibial nerves were lower than the standard values, and evoked potentials of the bilateral sural nerves were not detected. Needle electromyography showed polyphasic motor unit action potentials in the left tibialis anterior and right first dorsal interosseus muscles. Gene analysis disclosed a mutation (Trp77→stop codon) in the connexin 32. Therefore, we diagnosed him as having X-linked Charcot-Marie-Tooth disease. For rehabilitative treatments, we prescribed resistive exercises for the upper and lower extremities, prolonged stretching of the ankle joints on a standing board, and gait training with bilateral Lofstrand's crutches and shoe-horn type plastic ankle-foot orthosis. A standard wheelchair was also made available for going outside.

ANKLE WEIGHT EFFECT ON GAIT: ORTHOTIC IMPLICATIONS

Oxygen consumption during ambulation was measured in 10 normal subjects wearing ankle weights of 0.91 kg, 1.82 kg, and 2.73 kg, either on the right ankle or bilaterally. Subjects walked at self-selected speeds and oxygen consumption was measured over 1-minute intervals during steady-state walking. Oxygen consumption per unit distance and oxygen consumption rate demonstrated significant positive linear correlations with added weight (P = .001, P = 0.007, respectively). Velocity demonstrated a significant decrease when correlated with added weight (P = 0.03). Multiple regression analysis was used to relate these measures of oxygen consumption rates to velocity, age, and added weight, yielding predictive relationships. Based on these results, the weight of orthoses should be minimized in order to maximize walking velocity and minimize oxygen consumption per unit distance. The advantage of a light-weight, molded plastic ankle-foot orthosis (AFO) over heavier AFO designs is demonstrated by this study.

A Study of Effect and Evaluation of Trimming to Plastic Ankle-Foot Orthosis

A Study of Effect and Evaluation of Trimming to Plastic Ankle-Foot Orthosis