Article

In patients with central neurological disorders, gait is often limited by a
reduced ability to push off with the ankle. To overcome this reduced ankle
push-off, energy-storing, spring-like carbon-composite Ankle Foot Orthoses (AFO)
can be prescribed. It is expected that the energy returned by the AFO in late
stance will support ankle push-off, and reduce the energy cost of walking. In 10
patients with multiple sclerosis and stroke the energy cost of walking, 3D
kinematics, joint power, and joint work were measured during gait, with and
without the AFO. The mechanical characteristics of the AFO were measured
separately, and used to calculate the contribution of the AFO to the ankle
kinetics. We found a significant decrease of 9.8% in energy cost of walking when
walking with the AFO. With the AFO, the range of motion of the ankle was reduced
by 12.3 degrees , and the net work around the ankle was reduced by 29%. The total
net work in the affected leg remained unchanged. The AFO accounted for 60% of the
positive ankle work, which reduced the total amount of work performed by the leg
by 11.1% when walking with the AFO. The decrease in energy cost when walking with
a spring-like energy-storing AFO in central neurological patients is not induced
by an augmented net ankle push-off, but by the AFO partially taking over ankle
work.
CI - Copyright (c) 2011 Elsevier B.V. All rights reserved.

Langue : ANGLAIS