Gait patterns in association with underlying impairments in polio survivors with calf muscle weakness

Ploeger, Hilde E.; Bus, Sicco A.; Nollet, Frans; Brehm, Merel-Anne

doi:10.1016/j.gaitpost.2017.07.107

Cited by 27 publications

(29 citation statements)

References 22 publications

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“…Footplate stiffness differed significantly between AFO types (p < 0.001); both DF-stop AFOs (p = 0.004) and ventral AFOs (p = 0.002) had stiffer footplates than dorsal AFOs (see Table I). Indiviudal AFO properties can be found in the Appendix SI 1 No correlation was found between calf muscle strength (n = 21, r = 0.120, p = 0.603) or leg muscle strength (r = 0.221, p = 0.349) and AFO ankle stiffness (Fig. 1).…”

Section: Orthotic Propertiesmentioning

confidence: 92%

“…Mass differed significantly between the AFO types (range 0.3-1.0 kg, p < 0.001) (see Table I). Properites and effect of indiviual AFOs are presented in Appendix SI 1 Ankle stiffness was measured for 21 AFOs/OS. Stiffness was not measured for 4 OS as they did not fit in the BRUCE, for 2 ventral AFOs due to logistic issues as the BRUCE was located in another department, and for 1 ventral AFO and the DF-stop AFOs (when at the DF-stop) as these AFOs were completely rigid.…”

Section: Orthotic Propertiesmentioning

confidence: 99%

“…W eakness of the lower leg muscles due to nonspastic neuromuscular disorders, such as Charcot-Marie Tooth disease or poliomyelitis, often includes weakness of the calf muscles and foot dorsiflexors. As a consequence of calf muscle weakness, the patient's gait is usually characterized by excessive ankle dorsiflexion and persistent knee flexion during stance (1,2). Furthermore, ankle push-off is reduced (2).…”

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Description of orthotic properties and effects evaluation of ankle-foot orthoses in non-spastic calf muscle weakness

et al. 2020

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Ankle-foot orthoses are used to improve walking in persons with non-spastic calf muscle weakness. For best results the mechanical properties of the device should be matched with the patient's impairments. However, there are currently no guidelines about the optimal mechanical properties of ankle-foot orthoses, due to a lack of studies evaluating their effects and properties. In order to establish a baseline and guide further research, we conducted an overview of the mechanical properties and effects of the ankle-foot orthoses provided in usual care in the Netherlands. The results show that, in usual orthotic care, ankle-foot orthoses that are not optimally matched with the patient's impairments are provided to persons with non-spastic calf muscle weakness. Differences in ankle-foot orthoses ankle stiffness were related with their effects. In general, persons wearing ankle-foot orthoses with the greatest ankle and footplate stiffness showed the largest benefits with regard to improved walking ability, although this warrants further prospective research. Objective: To describe the orthotic properties and evaluate the effects of ankle-foot orthoses for calf muscle weakness in persons with non-spastic neuromuscular disorders compared with shoes-only. Design: Cross-sectional study. Subjects: Thirty-four persons who used ankle-foot orthoses for non-spastic calf muscle weakness. Methods: The following orthotic properties were measured: ankle-foot orthosis type, mass, and ankle and footplate stiffness. For walking with shoes-only and with the ankle-foot orthoses, walking speed, energy cost and gait biomechanics were assessed. Results: Four types of ankle-foot orthosis were identified: shaft-reinforced orthopaedic shoes (n = 6), ventral ankle-foot orthoses (n = 10), dorsal leaf ankle-foot orthoses (n = 12) and dorsiflexion-stop ankle-foot orthoses (n = 6). These types differed significantly with regards to mass, ankle-and footplate stiffness. Compared with shoes-only, all anklefoot orthoses/orthopaedic shoes groups combined increased walking speed by 0.18 m/s (95% confidence interval (95% CI) 0.13-0.23), reduced energy cost by 0.70 J/kg/m (95% CI 0.48-0.94) and limited ankle dorsiflexion by-3.0° (95% CI 1.3-4.7). Higher ankle-foot orthoses ankle stiffness correlated with greater reductions in walking energy cost and maximal ankle dorsiflexion angle. Conclusion: Ankle-foot orthoses for persons with non-spastic calf muscle weakness vary greatly in properties and effects on gait. The large variation in effectiveness may be due to differences in ankle stiffness, although this requires further prospective evaluation.

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Section: Orthotic Propertiesmentioning

confidence: 92%

Section: Orthotic Propertiesmentioning

confidence: 99%

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confidence: 99%

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Description of orthotic properties and effects evaluation of ankle-foot orthoses in non-spastic calf muscle weakness

et al. 2020

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“…Any excessive alteration of these compensatory mechanisms with an orthosis may worsen the individual's mobility and would not be tolerated . Gait patterns and individual gait parameters in post‐polio patients are also difficult to predict based solely on the polio‐related impairments demonstrated on examination . Thus, given these issues, it is important, when considering orthotic intervention, that these patients undergo an interdisciplinary assessment with a physiatrist/neurologist, orthotist, and physiotherapist, with gait assessment, to carefully assess the appropriateness of an orthosis for mobility.…”

Section: Treatment and Managementmentioning

confidence: 99%

Post‐polio syndrome and the late effects of poliomyelitis: Part 2. treatment, management, and prognosis

Robinson

2018

Muscle and Nerve

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Post-polio syndrome (PPS) is characterized by new muscle weakness and/or muscle fatigability that occurs many years after the initial poliomyelitis illness. An individualized approach to rehabilitation management is critical. Interventions may include rehabilitation management strategies, adaptive equipment, orthotic equipment, gait/mobility aids, and a variety of therapeutic exercises. The progression of muscle weakness in PPS is typically slow and gradual; however, there is also variability in both the natural history of weakness and functional prognosis. Further research is required to determine the effectiveness of selected medical treatment. Muscle Nerve, 2018.

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“…A compensatory hyperlordosis of the lumbar spine may be seen in patients with polio due to concomitant weakness in the quadriceps, hamstring, and gluteus maximus [2]. Patients with polio have various gait patterns according to the severity and affected muscles of the lower extremity [3]. In The Clubfoot, we believe a small, but important detail to examine is the stick, which shows an erosion around the boy's neck.…”

mentioning

confidence: 99%

Reply to the Letter to the Editor: Art in Science: Jusepe de Ribera’s Puzzle in The Clubfoot

Abul

Mısır

Büyük

2018

Clin Orthop Relat Res

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Gait patterns in association with underlying impairments in polio survivors with calf muscle weakness

Cited by 27 publications

References 22 publications

Description of orthotic properties and effects evaluation of ankle-foot orthoses in non-spastic calf muscle weakness

Description of orthotic properties and effects evaluation of ankle-foot orthoses in non-spastic calf muscle weakness

Post‐polio syndrome and the late effects of poliomyelitis: Part 2. treatment, management, and prognosis

Reply to the Letter to the Editor: Art in Science: Jusepe de Ribera’s Puzzle in The Clubfoot

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