Article

Ankle-foot orthoses (AFOs) can provide support and improve walking ability in
individuals with plantarflexor weakness. Passive-dynamic AFO stiffness can be
optimized for over-ground walking, however little research exists for uphill
walking, when plantarflexor contributions are key.
PURPOSE: Compare uphill
walking biomechanics (1) between dynamic AFO users and able-bodied control
subjects. (2) between injured and sound limbs (3) across different AFO
stiffnesses. METHODS: Twelve patients with unilateral limb-salvage and twelve
matched, able-bodied controls underwent biomechanical gait analysis when walking
up a 10 degrees incline. Three AFO stiffnesses were tested in the patient group:
Nominal (clinically prescribed), Compliant (20% less stiff), and Stiff (20% more
stiff). RESULTS AND DISCUSSION: AFO users experienced less ankle motion and power
generation, lower knee extensor moments, and greater hip flexion and power
generation than controls during uphill walking. Despite these deviations, they
walked at equivalent self-selected velocities and stride lengths. Asymmetries
were present at the ankle and knee with decreased ankle motion and power, and
lower knee extensor moments on the AFO limb. Stiffer AFOs increased knee joint
flexion but a 40% range in AFO stiffness had few other effects on gait.
Therefore, a wide range of clinically prescribed AFO stiffnesses may adequately
assist uphill walking.
CI - Published by Elsevier B.V.

Langue : ANGLAIS