The effect of hinged ankle-foot orthosis on gait and energy expenditure in spastic hemiplegic cerebral palsy

Balaban, Birol; Yaşar, Evren; Dal, Uğur; Yazıcıoğlu, Kamil; Möhür, Haydar; Kalyon, Tunc Alp

doi:10.1080/17483100600876740

Cited by 69 publications

(60 citation statements)

References 13 publications

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“…Gait disabilities such as cerebral palsy, lower extremity amputation and stroke increase the energy expenditure of walking [3][4][5]. The energy consumption of walking relates to the intensity of physical effort and can be affected by the alterations in walking speed [1].…”

Section: Introductionmentioning

confidence: 99%

Determination of preferred walking speed on treadmill may lead to high oxygen cost on treadmill walking

et al. 2010

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Section: Introductionmentioning

confidence: 99%

Determination of preferred walking speed on treadmill may lead to high oxygen cost on treadmill walking

et al. 2010

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“…Many of these studies find a small but significant improvement in gait with the use of AFOs. Studies of both spastic di- and hemiplegic subjects have found that wearing AFOs, compared to walking barefoot, resulted in increases in stride length (Abel et al 1998;Balaban et al 2007;Buckon et al 2001;Buckon et al 2004;Carlson et al 1997;Dursun et al 2002;Lam et al 2005;Romkes & Brunner 2002;Smith et al 2009;White et al 2002), and increases in comfortable walking velocity(Abel et al 1998;Balaban et al 2007;Brehm et al 2008;Dursun et al 2002;Franceschini et al 2003;Smith et al 2009;Van de Walle et al 2009;White et al 2002). Studies have also found AFO use can reduce the metabolic cost of walking(Balaban et al 2007;Buckon et al 2004;Franceschini et al 2003;Maltais et al 2001).…”

Section: Introductionmentioning

confidence: 99%

The effects of ankle foot orthoses on energy recovery and work during gait in children with cerebral palsy

Bennett¹,

Russell²,

Abel³

2012

Clinical Biomechanics

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Background Studies suggest that 50% of children with cerebral palsy are prescribed ankle foot orthoses. One of the aims of ankle foot orthosis use is to aid in walking. This research examined the effects that ankle foot orthoses have on the energy recovery and the mechanical work performed by children with cerebral palsy during walking. Methods Twenty-one children with spastic diplegia walked with and without their prescribed bilateral ankle foot orthoses. Ten of the subjects wore articulated (hinged) orthoses and 11 subjects wore solid orthoses. Three dimensional kinematic data were collected and between and within group repeated measures ANOVAs were applied to the dependent measures. Findings The results were similar for both groups. There was an increase in stride length, energy recovery, and potential energy and the kinetic energy variation. There was no change in the mechanical work performed to walk or the normalized center of mass vertical excursion. Unfortunately, the increase in energy recovery did not alter the external work, as it was offset by increased variation in the potential and kinetic energies of the center of mass. There was a great deal of variability in the measured work, with both large increases and decreases in the work of individual subjects when wearing orthoses. Interpretation These results suggest that current ankle foot orthoses can reduce the work to walk, but do not do so for many children with cerebral palsy. This research suggests that ankle foot orthosis prescription could be aided by measuring the mechanical work during walking.

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“…23 A recent theoretical study using a simple model showed the ability to predict the displacement of the cuff band due to misalignment of AFO. 2 Articulated or hinged AFO allows more range of motion (ROM) compared to solid AFO 24 and its effect on improving gait is reported in studies on patients with spastic hemiplegic cerebral palsy 25 and stroke. 26 In addition, dorsiflexion assist is essential especially in patients with foot drop and difficulty in foot clearance.…”

Section: Introductionmentioning

confidence: 99%

Effects of joint alignment and type on mechanical properties of thermoplastic articulated ankle-foot orthosis

Gao

Carlton

Kapp

2011

Prosthetics &Amp; Orthotics International

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Background: Articulated or hinged ankle-foot orthosis (AFO) allow more range of motion. However, quantitative investigation on articulated AFO is still sparse. Objective: The objective of the study was to quantitatively investigate effects of alignment and joint types on mechanical properties of the thermoplastic articulated AFO. Study design: Tamarack dorsiflexion assist flexure joints with three durometers (75, 85 and 95) and free motion joint were tested. The AFO joint was aligned with the center of the motor shaft (surrogate ankle joint), 10 mm superior, inferior, anterior and posterior with respect to the motor shaft center. Methods: The AFO was passively moved from 20 plantar flexion to 15 dorsiflexion at a speed of 10 /s using a motorized device. Mechanical properties including index of hysteresis, passive resistance torque and quasi-static stiffness (at neutral, 5, 10 and 15 in plantar flexion) were quantified. Results: Significant effects of joint types and joint alignment on the mechanical properties of an articulated thermoplastic AFO were revealed. Specifically, center alignment showed minimum resistance and stiffness while anterior and posterior alignment showed significantly higher resistance and stiffness. The dorsiflexion assist torques at neutral position ranged from 0.69 AE 0.09 to 1.88 AE 0.10 Nm. Conclusions: Anterior and posterior alignment should be avoided as much as possible. Clinical relevanceThe current study suggested that anterior and posterior alignment be avoided as much as possible in clinical practice due to potential skin irritation and increase in stress around the ankle joint.

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The effect of hinged ankle-foot orthosis on gait and energy expenditure in spastic hemiplegic cerebral palsy

Abstract: The hinged AFO is useful in controlling dynamic equinus deformity and reducing the energy expenditure of gait in children with hemiplegic spastic cerebral palsy.

Cited by 69 publications

References 13 publications

Determination of preferred walking speed on treadmill may lead to high oxygen cost on treadmill walking

Determination of preferred walking speed on treadmill may lead to high oxygen cost on treadmill walking

The effects of ankle foot orthoses on energy recovery and work during gait in children with cerebral palsy

Effects of joint alignment and type on mechanical properties of thermoplastic articulated ankle-foot orthosis

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