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Ankle dorsiflexion assistance of patients with foot drop using a powered ankle-foot orthosis to improve the gait asymmetry

BACKGROUND: Foot drop is a neuromuscular disorder that causes abnormal gait patterns. This study developed a pneumatically powered ankle-foot orthosis (AFO) to improve the gait patterns of patients with foot drop. We hypothesized that providing unilateral ankle dorsiflexion assistance during the swi...

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Autores principales: Shin, Wonseok, Nam, Dongwoo, Ahn, Bummo, Kim, Sangjoon J., Lee, Dong Yeon, Kwon, Suncheol, Kim, Jung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10589991/
https://www.ncbi.nlm.nih.gov/pubmed/37864265
http://dx.doi.org/10.1186/s12984-023-01261-1
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author Shin, Wonseok
Nam, Dongwoo
Ahn, Bummo
Kim, Sangjoon J.
Lee, Dong Yeon
Kwon, Suncheol
Kim, Jung
author_facet Shin, Wonseok
Nam, Dongwoo
Ahn, Bummo
Kim, Sangjoon J.
Lee, Dong Yeon
Kwon, Suncheol
Kim, Jung
author_sort Shin, Wonseok
collection PubMed
description BACKGROUND: Foot drop is a neuromuscular disorder that causes abnormal gait patterns. This study developed a pneumatically powered ankle-foot orthosis (AFO) to improve the gait patterns of patients with foot drop. We hypothesized that providing unilateral ankle dorsiflexion assistance during the swing phase would improve the kinematics and spatiotemporal gait parameters of such patients. Accordingly, this study aims to examine the efficacy of the proposed assistance system using a strategy for joint kinematics and spatiotemporal gait parameters (stride length, swing velocity, and stance phase ratio). The analysis results are expected to provide knowledge for better design and control of AFOs in patients with foot drop. METHOD: Ten foot drop patients with hemiparesis (54.8 y ± 14.1 y) were fitted with a custom AFO with an adjustable calf brace and portable air compressor for ankle dorsiflexion assistance in the gait cycle during the swing phase. All subjects walked under two different conditions without extensive practice: (1) barefoot and (2) wearing a powered AFO. Under each condition, the patients walked back and forth on a 9-m track with ten laps of level ground under the supervision of licensed physical therapists. The lower-limb joint and trunk kinematics were acquired using 12 motion-capture cameras. RESULTS: We found that kinematic asymmetry decreased in the three lower-limb joints after ankle dorsiflexion assistance during the swing phase. The average ankle-joint angle increased after using the AFO during the entire gait cycle. Similarly, the knee-joint angle showed a slight increase while using the AFO, leading to a significantly decreased standard deviation within patients. Conversely, the hip-joint angle showed no significant improvements with assistance. While several patients exhibited noticeably lower levels of asymmetry, no significant changes were observed in the average asymmetry of the swing velocity difference between the affected and unaffected sides while using the AFO. CONCLUSION: We experimentally validated that ankle dorsiflexion assistance during the swing phase temporarily improves gait asymmetry in foot-drop patients. The experimental results also prove the efficacy of the developed AFO for gait assistance in foot-drop patients.
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spelling pubmed-105899912023-10-22 Ankle dorsiflexion assistance of patients with foot drop using a powered ankle-foot orthosis to improve the gait asymmetry Shin, Wonseok Nam, Dongwoo Ahn, Bummo Kim, Sangjoon J. Lee, Dong Yeon Kwon, Suncheol Kim, Jung J Neuroeng Rehabil Research BACKGROUND: Foot drop is a neuromuscular disorder that causes abnormal gait patterns. This study developed a pneumatically powered ankle-foot orthosis (AFO) to improve the gait patterns of patients with foot drop. We hypothesized that providing unilateral ankle dorsiflexion assistance during the swing phase would improve the kinematics and spatiotemporal gait parameters of such patients. Accordingly, this study aims to examine the efficacy of the proposed assistance system using a strategy for joint kinematics and spatiotemporal gait parameters (stride length, swing velocity, and stance phase ratio). The analysis results are expected to provide knowledge for better design and control of AFOs in patients with foot drop. METHOD: Ten foot drop patients with hemiparesis (54.8 y ± 14.1 y) were fitted with a custom AFO with an adjustable calf brace and portable air compressor for ankle dorsiflexion assistance in the gait cycle during the swing phase. All subjects walked under two different conditions without extensive practice: (1) barefoot and (2) wearing a powered AFO. Under each condition, the patients walked back and forth on a 9-m track with ten laps of level ground under the supervision of licensed physical therapists. The lower-limb joint and trunk kinematics were acquired using 12 motion-capture cameras. RESULTS: We found that kinematic asymmetry decreased in the three lower-limb joints after ankle dorsiflexion assistance during the swing phase. The average ankle-joint angle increased after using the AFO during the entire gait cycle. Similarly, the knee-joint angle showed a slight increase while using the AFO, leading to a significantly decreased standard deviation within patients. Conversely, the hip-joint angle showed no significant improvements with assistance. While several patients exhibited noticeably lower levels of asymmetry, no significant changes were observed in the average asymmetry of the swing velocity difference between the affected and unaffected sides while using the AFO. CONCLUSION: We experimentally validated that ankle dorsiflexion assistance during the swing phase temporarily improves gait asymmetry in foot-drop patients. The experimental results also prove the efficacy of the developed AFO for gait assistance in foot-drop patients. BioMed Central 2023-10-20 /pmc/articles/PMC10589991/ /pubmed/37864265 http://dx.doi.org/10.1186/s12984-023-01261-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Shin, Wonseok
Nam, Dongwoo
Ahn, Bummo
Kim, Sangjoon J.
Lee, Dong Yeon
Kwon, Suncheol
Kim, Jung
Ankle dorsiflexion assistance of patients with foot drop using a powered ankle-foot orthosis to improve the gait asymmetry
title Ankle dorsiflexion assistance of patients with foot drop using a powered ankle-foot orthosis to improve the gait asymmetry
title_full Ankle dorsiflexion assistance of patients with foot drop using a powered ankle-foot orthosis to improve the gait asymmetry
title_fullStr Ankle dorsiflexion assistance of patients with foot drop using a powered ankle-foot orthosis to improve the gait asymmetry
title_full_unstemmed Ankle dorsiflexion assistance of patients with foot drop using a powered ankle-foot orthosis to improve the gait asymmetry
title_short Ankle dorsiflexion assistance of patients with foot drop using a powered ankle-foot orthosis to improve the gait asymmetry
title_sort ankle dorsiflexion assistance of patients with foot drop using a powered ankle-foot orthosis to improve the gait asymmetry
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10589991/
https://www.ncbi.nlm.nih.gov/pubmed/37864265
http://dx.doi.org/10.1186/s12984-023-01261-1
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