Article

The Intrepid Dynamic Exoskeletal Orthosis is a custom-made dynamic
response carbon fiber device.
A heel wedge, which sits in the shoe, is an
integral part of the orthosis-heel wedge-shoe system. Because the device
restricts ankle movement, the system must compensate to simulate plantarflexion
and allow smooth forward progression during gait. OBJECTIVES: To determine the
influence of wedge height and durometer on the walking gait of individuals using
the Intrepid Dynamic Exoskeletal Orthosis. STUDY DESIGN: Repeated measures.
METHODS: Twelve individuals walked over level ground with their Intrepid Dynamic
Exoskeletal Orthosis and six different heel wedges of soft or firm durometer and
1, 2, or 3 cm height. Center of pressure velocity, joint moments, and roll-over
shape were calculated for each wedge. RESULTS: Height and durometer significantly
affected time to peak center of pressure velocity, time to peak internal
dorsiflexion and knee extension moments, time to ankle moment zero crossing, and
roll-over shape center of curvature anterior-posterior position. Wedge height had
a significant influence on peak center of pressure velocity, peak dorsiflexion
moment, time to peak knee extension moment, and roll-over shape radius and
vertical center of curvature. CONCLUSION: Changes in wedge height and durometer
systematically affected foot loading. Participants preferred wedges which
produced ankle moment zero crossing timing, peak internal knee extension moment
timing, and roll-over shape center of curvature anterior-posterior position close
to that of able-bodied individuals. Clinical relevance Adjusting the heel wedge
is a simple, straightforward way to adjust the orthosis-heel wedge-shoe system.
Changing wedge height and durometer significantly alters loading of the foot and
has great potential to improve an individual's gait.

Langue : ANGLAIS