The Shank-to-Vertical-Angle as a parameter to evaluate tuning of Ankle-Foot Orthoses

Kerkum, Yvette L.; Houdijk, Han; Brehm, Merel-Anne; Buizer, Annemieke I.; Kessels, M.L.C.; Sterk, Arjan; Noort, Josien C. van den; Harlaar, Jaap

doi:10.1016/j.gaitpost.2015.05.016

Cited by 31 publications

(35 citation statements)

References 22 publications

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“…Joint moments also make it possible to evaluate muscle strength, training effect of rehabilitation and so on. Especially, lower limb joint moments have been studied for evaluation of muscle strength in relation to balance recovery performance [ 7 , 8 ]; movement strategies [ 9 , 10 ] of elderly subjects, and in evaluation of individuals with Parkinson's disease [ 11 ], hemiparesis [ 12 ] and cerebral palsy [ 13 , 14 ]; and used as evaluation indexes for rehabilitation [ 15 , 16 , 17 ], joint arthroplasty [ 18 , 19 , 20 ] and tuning of ankle-foot orthoses [ 21 , 22 ]. These various studies show that joint moments can be useful as one of quantitative indexes of rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Examination of Inertial Sensor-Based Estimation Methods of Lower Limb Joint Moments and Ground Reaction Force: Results for Squat and Sit-to-Stand Movements in the Sagittal Plane

Kodama

Watanabe

2016

Sensors

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Joint moment estimation by a camera-based motion measurement system and a force plate has a limitation of measurement environment and is costly. The purpose of this paper is to evaluate quantitatively inertial sensor-based joint moment estimation methods with five-link, four-link and three-link rigid body models using different trunk segmented models. Joint moments, ground reaction forces (GRF) and center of pressure (CoP) were estimated for squat and sit-to-stand movements in the sagittal plane measured with six healthy subjects. The five-link model and the four-link model that the trunk was divided at the highest point of the iliac crest (four-link-IC model) were appropriate for joint moment estimation with inertial sensors, which showed average RMS values of about 0.1 Nm/kg for all lower limb joints and average correlation coefficients of about 0.98 for hip and knee joints and about 0.80 for ankle joint. Average root mean square (RMS) errors of horizontal and vertical GRFs and CoP were about 10 N, 15 N and 2 cm, respectively. Inertial sensor-based method was suggested to be an option for estimating joint moments of the trunk segments. Inertial sensors were also shown to be useful for the bottom-up estimation method using measured GRFs, in which average RMS values and average correlation coefficients were about 0.06 Nm/kg and larger than about 0.98 for all joints.

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Section: Introductionmentioning

confidence: 99%

Examination of Inertial Sensor-Based Estimation Methods of Lower Limb Joint Moments and Ground Reaction Force: Results for Squat and Sit-to-Stand Movements in the Sagittal Plane

Kodama

Watanabe

2016

Sensors

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“…Orientation of the shank has been previously used for orthotic tuning, prosthetic alignment, and biofeedback training. [5][6][7][8][9][10] This research demonstrated that smartphone accelerometers can accurately and repeatedly monitor SVA when used by licensed clinicians during unimpaired gait.…”

Section: Discussionmentioning

confidence: 67%

“…SVA was calculated for both anterior and lateral methods of measurement using markers placed on the shank. 6 The anterior position was assessed using markers placed on the TT and distal tibia (DT). The lateral position was assessed using markers placed on the LE and LM (Figure 1(b)).…”

Section: Svamentioning

confidence: 99%

“…For orthotists and prosthetists, SVA is a metric used for device prescription. [5][6][7][8][9][10] While marker-based 3D motion analysis remains the gold standard for assessing human movement, 3 the technology and personnel required is generally not available in the clinic. Instead, measures like SVA can be used to prescribe devices and guide treatment decisions.…”

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confidence: 99%

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Accuracy and repeatability of smartphone sensors for measuring shank-to-vertical angle

Nguyen

Baicoianu

Howell

et al. 2020

Prosthetics &Amp; Orthotics International

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Background: Assessments of human movement are clinically important. However, accurate measurements are often unavailable due to the need for expensive equipment or intensive processing. For orthotists and therapists, shank-to-vertical angle is one critical measure used to assess gait and guide prescriptions. Smartphone-based sensors may provide a widely available platform to expand access to this measurement. Objectives: Assess accuracy and repeatability of smartphone-based measurement of shank-to-vertical angle compared to marker-based 3D motion analysis. Study design: Repeated-measures. Methods: Four licensed clinicians (two physical therapists and two orthotists) measured shank-to-vertical angle during gait with a smartphone attached to the anterior or lateral shank surface of unimpaired adults. We compared the shank-to-vertical angle calculated from the smartphone’s inertial measurement unit to marker-based measurements. Each clinician completed three sessions/day on two days with each participant to assess repeatability. Results: Average absolute differences in shank-to-vertical angle measured with a smartphone versus marker-based 3D motion analysis during gait were 0.67 ± 0.25° and 4.89 ± 0.72°, with anterior or lateral smartphone positions, respectively. The inter- and intra-day repeatability of shank-to-vertical angle were within 2° for both smartphone positions. Conclusions: Smartphone sensors can be used to measure shank-to-vertical angle with high accuracy and repeatability during unimpaired gait, providing a widely available tool for quantitative gait assessments. Clinical relevance Smartphone sensors demonstrated high accuracy and repeatability for monitoring shank-to-vertical angle during gait. Measurement of shank-to-vertical angle from the front of the shank was more accurate than the side of the shank. Smartphones may expand access to quantitative assessments of gait.

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“…To effectively alter the ankle angle, substantial ankle stiffness is needed to restrain the uncontrolled forward rotation of the tibia in the sagittal plane during stance, as typically seen in persons with non-spastic calf muscle weakness (19,21,35). Furthermore, higher footplate stiffness helps to move the origin of the ground reaction force forward underneath the foot during stance (36,37), which would increase the external ankle and knee moment. We argue that the stiffness of the ankle and footplate of OS and dorsal AFOs were generally too low in our sample, as a high percentage of users showed little effect on the gait biomechanics compared with ventral and DF-stop AFOs users (see Fig.…”

Section: Discussionmentioning

confidence: 99%

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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The Shank-to-Vertical-Angle as a parameter to evaluate tuning of Ankle-Foot Orthoses

Cited by 31 publications

References 22 publications

Examination of Inertial Sensor-Based Estimation Methods of Lower Limb Joint Moments and Ground Reaction Force: Results for Squat and Sit-to-Stand Movements in the Sagittal Plane

Examination of Inertial Sensor-Based Estimation Methods of Lower Limb Joint Moments and Ground Reaction Force: Results for Squat and Sit-to-Stand Movements in the Sagittal Plane

Accuracy and repeatability of smartphone sensors for measuring shank-to-vertical angle

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

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