Passive-dynamic ankle-foot orthosis replicates soleus but not gastrocnemius muscle function during stance in gait: Insights for orthosis prescription

被引：28

作者：

Arch, Elisa S. ^{[1
]}

Stanhope, Steven J. ^{[1
]}

Higginson, Jill S. ^{[1
]}

机构：

[1] Univ Delaware, 540 South Coll Ave, Newark, DE 19713 USA

来源：

PROSTHETICS AND ORTHOTICS INTERNATIONAL | 2016年 / 40卷 / 05期

基金：

美国国家科学基金会;

关键词：

Gastrocnemius; induced acceleration analysis; orthotic; plantar flexor; soleus; stiffness; HUMAN WALKING; AMPUTEE WALKING; ENERGY-COST; KNEE-JOINT; SIMULATIONS; SUPPORT; PROGRESSION; SPEED; HIP; BIOMECHANICS;

D O I：

10.1177/0309364615592693

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

100224 [整形外科学];

摘要：

Background: Passive-dynamic ankle-foot orthosis characteristics, including bending stiffness, should be customized for individuals. However, while conventions for customizing passive-dynamic ankle-foot orthosis characteristics are often described and implemented in clinical practice, there is little evidence to explain their biomechanical rationale. Objectives: To develop and combine a model of a customized passive-dynamic ankle-foot orthosis with a healthy musculoskeletal model and use simulation tools to explore the influence of passive-dynamic ankle-foot orthosis bending stiffness on plantar flexor function during gait. Study design: Dual case study. Methods: The customized passive-dynamic ankle-foot orthosis characteristics were integrated into a healthy musculoskeletal model available in OpenSim. Quasi-static forward dynamic simulations tracked experimental gait data under several passive-dynamic ankle-foot orthosis conditions. Predicted muscle activations were calculated through a computed muscle control optimization scheme. Results: Simulations predicted that the passive-dynamic ankle-foot orthoses substituted for soleus but not gastrocnemius function. Induced acceleration analyses revealed the passive-dynamic ankle-foot orthosis acts like a uniarticular plantar flexor by inducing knee extension accelerations, which are counterproductive to natural knee kinematics in early midstance. Conclusion: These passive-dynamic ankle-foot orthoses can provide plantar flexion moments during mid and late stance to supplement insufficient plantar flexor strength. However, the passive-dynamic ankle-foot orthoses negatively influenced knee kinematics in early midstance. Clinical relevance Identifying the role of passive-dynamic ankle-foot orthosis stiffness during gait provides biomechanical rationale for how to customize passive-dynamic ankle-foot orthoses for patients. Furthermore, these findings can be used in the future as the basis for developing objective prescription models to help drive the customization of passive-dynamic ankle-foot orthosis characteristics.

引用

页码：606 / 616

页数：11

共 48 条

[1]

A new carbon fibre spring orthosis for children with plantarflexor weakness [J].

Bartonek, Asa ;

Eriksson, Marie ;

Gutierrez-Farewik, Elena M. .

GAIT & POSTURE, 2007, 25 (04) :652-656

[2]

Spring-like Ankle Foot Orthoses reduce the energy cost of walking by taking over ankle work [J].

Bregman, D. J. J. ;

Harlaar, J. ;

Meskers, C. G. M. ;

de Groot, V. .

GAIT & POSTURE, 2012, 35 (01) :148-153

[3]

The effect of ankle foot orthosis stiffness on the energy cost of walking: A simulation study [J].

Bregman, D. J. J. ;

van der Krogt, M. M. ;

de Groot, V. ;

Harlaar, J. ;

Wisse, M. ;

Collins, S. H. .

CLINICAL BIOMECHANICS, 2011, 26 (09) :955-961

[4]

A new method for evaluating ankle foot orthosis characteristics: BRUCE [J].

Bregman, D. J. J. ;

Rozumalski, A. ;

Koops, D. ;

de Groot, V. ;

Schwartz, M. ;

Harlaar, J. .

GAIT & POSTURE, 2009, 30 (02) :144-149

[5]

Polypropylene ankle foot orthoses to overcome drop-foot gait in central neurological patients: A mechanical and functional evaluation [J].

Bregman, Daan J. J. ;

De Groot, Vincent ;

Van Diggele, Peter ;

Meulman, Hubert ;

Houdijk, Han ;

Harlaar, Jaap .

PROSTHETICS AND ORTHOTICS INTERNATIONAL, 2010, 34 (03) :293-304

[6]

A candidate core set of outcome measures based on the international classification of functioning, disability and health for clinical studies on lower limb orthoses [J].

Brehm, Merel ;

Bus, Sicco A. ;

Harlaar, Jaap ;

Nollet, Frans .

PROSTHETICS AND ORTHOTICS INTERNATIONAL, 2011, 35 (03) :269-277

[7]

The modern era of orthotics [J].

Condie, David N. .

PROSTHETICS AND ORTHOTICS INTERNATIONAL, 2008, 32 (03) :313-323

[8]

Modeling neuromuscular effects of ankle foot orthoses (AFOs) in computer simulations of gait [J].

Crabtree, Charles A. ;

Higginson, Jill S. .

GAIT & POSTURE, 2009, 29 (01) :65-70

[9]

Davis R.B., 1996, GAIT POSTURE, V4, P224, DOI 10.1016/0966-6362(95)01045-9

[10]

OpenSim: open-source software to create and analyze dynamic Simulations of movement [J].

Delp, Scott L. ;

Anderson, Frank C. ;

Arnold, Allison S. ;

Loan, Peter ;

Habib, Ayman ;

John, Chand T. ;

Guendelman, Eran ;

Thelen, Darryl G. .

IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, 2007, 54 (11) :1940-1950

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