The effect of changing plantarflexion resistive moment of an articulated ankle-foot orthosis on ankle and knee joint angles and moments while walking in patients post stroke.
The effect of changing plantarflexion resistive moment of an articulated ankle-foot orthosis on ankle and knee joint angles and moments while walking in patients post stroke.
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DOI：
10.1016/j.clinbiomech.2015.06.014
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发表时间：
2015-10
期刊：
影响因子：
--
通讯作者：
Foreman KB
中科院分区：
文献类型：
--
作者：
Kobayashi T;Singer ML;Orendurff MS;Gao F;Daly WK;Foreman KB
关节踝足矫形器的屈膝阻力矩的调节在中风后的患者中被认为是重要的，但证据仍然有限。因此，本研究的目的是研究改变关节踝足矫形器的足底屈曲阻力力矩对中风后患者踝关节和膝关节角度和力矩的影响。使用一种新设计的关节踝足矫形器，对10名中风后受试者在4种不同的趾屈阻力矩条件下进行了步态分析。数据是在三维运动分析实验室中使用Bertec分体式皮带仪表式跑步机记录的。踝足矫形器屈膝阻力力矩的大小对踝关节和膝关节矢状关节的角度和力矩有显著影响。增加踝足矫形器的屈膝阻力矩可使踝关节最大屈曲角度(P<；0.01)和膝关节最大伸展角度(P<；0.05)显著降低。踝关节内屈力矩显著增加(P<；0.01)，膝关节内屈力矩显著降低(P<；0.01)。这些结果表明，关节踝足矫形器的足底屈曲阻力力矩与下肢关节的运动学/运动学参数之间存在重要的联系。未来应该进行一项研究，进一步阐明它们之间的关系，以便从业者能够使用这些参数作为客观数据来确定关节踝足矫形器的最佳屈膝阻力矩，以改善个别患者的矫形护理。
The adjustment of plantarflexion resistive moment of an articulated ankle-foot orthosis is considered important in patients post stroke, but the evidence is still limited. Therefore, the aim of this study was to investigate the effect of changing the plantarflexion resistive moment of an articulated ankle-foot orthosis on ankle and knee joint angles and moments in patients post stroke. Gait analysis was performed on 10 subjects post stroke under four different plantarflexion resistive moment conditions using a newly designed articulated ankle-foot orthosis. Data were recorded using a Bertec split-belt instrumented treadmill in a 3-dimensional motion analysis laboratory. The ankle and knee sagittal joint angles and moments were significantly affected by the amount of plantarflexion resistive moment of the ankle-foot orthosis. Increasing the plantarflexion resistive moment of the ankle-foot orthosis induced significant decreases both in the peak ankle plantarflexion angle (P<0.01) and the peak knee extension angle (P<0.05). Also, the increase induced significant increases in the internal dorsiflexion moment of the ankle joint (P<0.01) and significantly decreased the internal flexion moment of the knee joint (P<0.01). These results suggest an important link between the kinematic/kinetic parameters of the lower-limb joints and the plantarflexion resistive moment of an articulated ankle-foot orthosis. A future study should be performed to clarify their relationship further so that the practitioners may be able to use these parameters as objective data to determine an optimal plantarflexion resistive moment of an articulated ankle-foot orthosis for improved orthotic care in individual patients.