The influence of solid ankle-foot-orthoses on forward propulsion and dynamic balance in healthy adults during walking
The influence of solid ankle-foot-orthoses on forward propulsion and dynamic balance in healthy adults during walking
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DOI：
10.1016/j.clinbiomech.2014.02.007
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发表时间：
2014-05-01
影响因子：
1.8
通讯作者：
Neptune, Richard R.
中科院分区：
文献类型：
--
作者：
Vistamehr, Arian;Kautz, Steven A.;Neptune, Richard R.
背景资料：在中风后轻偏瘫患者中，通常规定使用实心聚丙烯踝足矫形器，以在摆动期间帮助足部间隙，同时在站立期间支撑踝关节。移动性需求，如改变行走速度和方向，是通过加速或减速身体和保持动态平衡来实现的。先前的研究表明，踝跖屈肌是这些基本生物力学功能的主要贡献者。因此，在踝足矫形器限制站立期间的踝运动和跖屈肌输出的情况下，这些行走子任务的执行可能受到损害。本研究探讨了固体聚丙烯踝足矫形器对健康成年人前向推进和动态平衡的影响。方法：运动学和动力学数据记录了10名健康成年人在稳态缓慢步行时带和不带单侧踝足矫形器（0.6 m/s）和中等（1.2 m/s）速度，以及在加速（0-1.8 m/s，0.06 m/s（2））和减速（1.8-0 m/s，-0.06 m/s（2））行走期间。通过推进和制动脉冲来量化推进（即，时间积分的前-后地面反作用力），而动态平衡被量化的峰-峰范围的全身角momentation.Findings：的推进冲动减少，在腿与踝足矫形器相比，对侧腿，没有踝足矫形器的条件。此外，踝足矫形器导致在更大范围内的角动量在额状面和矢状面，这与减少峰值髋关节外展和减少踝跖屈肌moments.Interpretation：坚实的踝足矫形器限制成功执行重要的流动性子任务在健康的成年人和处方的踝足矫形器应仔细考虑。(C)2014爱思唯尔有限公司版权所有。
Background: In post-stroke hemiparetic subjects, solid polypropylene ankle-foot-orthoses are commonly prescribed to assist in foot clearance during swing while bracing the ankle during stance. Mobility demands, such as changing walking speed and direction, are accomplished by accelerating or decelerating the body and maintaining dynamic balance. Previous studies have shown that the ankle plantarflexors are primary contributors to these essential biomechanical functions. Thus, with ankle-foot-orthoses limiting ankle motion and plantarflexor output during stance, execution of these walking subtasks may be compromised. This study examined the influence of a solid polypropylene ankle-foot-orthosis on forward propulsion and dynamic balance in healthy adults.Methods: Kinematic and kinetic data were recorded from 10 healthy adults walking with and without a unilateral ankle-foot-orthosis at steady-state slow (0.6 m/s) and moderate (1.2 m/s) speeds, and during accelerated (0-1.8 m/s at 0.06 m/s(2)) and decelerated (1.8-0 m/s at - 0.06 m/s(2)) walking. Propulsion was quantified by propulsive and braking impulses (i.e., time integral of the anterior-posterior ground reaction force) while dynamic balance was quantified by the peak-to-peak range of whole-body angular momentum.Findings: The propulsive impulses decreased in the leg with ankle-foot-orthosis compared to the contralateral leg and no ankle-foot-orthosis condition. Further, the ankle-foot-orthosis resulted in a greater range of angular momentum in both the frontal and sagittal planes, which were correlated with the reduced peak hip abduction and reduced ankle plantarflexor moments, respectively.Interpretation: Solid ankle-foot-orthoses limit the successful execution of important mobility subtasks in healthy adults and that the prescription of ankle-foot-orthosis should be carefully considered. (C) 2014 Elsevier Ltd. All rights reserved.