Collaborative Research: Don’t forget the foot! Exposing foot energetics to enhance foot orthoses and gait rehabilitation

足部和脚踝在有效行走的能力中起着重要作用，这对于独立生活和整体生活质量至关重要。然而，足部在行走效率中的作用尚未得到很好的理解，这限制了未来辅助设备的创新。这对力量受损的患者和踝足辅助行走装置的设计具有启示意义。本研究旨在揭示控制足部能量学的机制，并将这一新的认识应用于使用新型足部支架辅助踝关节-足部损伤患者的行走。预计从这项工作中获得的知识将促进对足部在行走中的作用的理解的转变，这将应用于下一代足部和踝足辅助装置的设计。作为这个合作研究项目的一部分，一大批研究生、本科生和高中生将接受多学科研究方面的培训。本研究的目的是揭示控制人类足部能量学机制的关键理解，并应用这种理解来探测和调节踝足系统的能量学，使用一种新的足矫形器。这一目标将分三部分实现。首先，跖趾关节的运动将通过一系列活动被系统地操纵，并通过新颖的动力学、多段足部建模来研究足部力量和功的相关变化。这将提供能量如何在健康的踝足系统中使用和转移的关键知识，并增强解释用于捕获和量化足部能量学的测量的能力。接下来，将使用一种具有定制前足刚度的新型可变形足矫形器来探索踝足能量的使用和传递，以更深入地了解健康足的能量学及其与踝关节的相互作用。健康的个体将在鞋子条件下行走，代表不同的前足刚度水平，同时收集能量和生物力学运动分析数据。最后，作为可行性研究的证明，中风后的个体将在三种条件下行走——赤脚、柔性鞋和调整前脚刚度的定制矫形器——同时收集能量和生物力学运动捕捉数据。本研究的最终目的是确定一种具有定制前足刚度的可变形足矫形器是否可以用于增强踝关节-足系统的能量，用于踝关节-足能量受损的个体。这项研究将提供对人类足部能量学的关键理解，以及健康和受损个体如何调节脚踝和足部的能量使用和转移。该项目由残疾与康复工程项目和促进竞争性研究的既定项目（EPSCoR）共同资助。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

The foot and ankle play a major role in the ability to walk efficiently, which is essential for independent living and overall quality of life. Yet, the foot’s role in walking efficiency is not well understood, limiting innovation of future assistive devices. This has implications for patients with compromised strength and for the design of ankle-foot assistive devices for walking. This study aims to reveal the mechanisms that control foot energetics and apply this new understanding to assist walking for individuals with ankle-foot impairments using a novel foot brace. It is anticipated that the knowledge gained from this work will spur a shift in understanding of the foot’s role in walking, which will be applied to the design of next generation foot and ankle-foot assistive devices. As part of this collaborative research project, a broad group of graduate, undergraduate, and high school students will be trained in multidisciplinary research. The objective of this research is to reveal critical understandings of the mechanisms governing the energetics of the human foot and apply this understanding to probe and modulate the energetics of the ankle-foot systems using a novel foot orthosis. This objective will be achieved in three parts. First, metatarsophalangeal joint motion will be systematically manipulated through a series of activities and the associated changes in foot power and work will be studied via novel kinetic, multi-segment foot modeling. This will provide critical knowledge of how energy is used and transferred in the healthy ankle-foot system and enhance the ability to interpret measurements used to capture and quantify foot energetics. Next, ankle-foot energy usage and transfer will be probed using a novel deformable foot orthosis with customized forefoot stiffness to gain a deeper understanding of the healthy foot’s energetics as well as its interaction with the ankle joint. Healthy individuals will walk under footwear conditions, representing varying forefoot stiffness levels, while energetic and biomechanical motion analysis data are collected. Finally, as a proof-of-feasibility study, individuals post-stroke will walk under three conditions - barefoot, flexible shoes, and a custom orthosis with tuned forefoot stiffness - while energetic and biomechanical motion capture data are collected. The goal of this final objective is to determine if a deformable foot orthosis with customized forefoot stiffness can be used to enhance the energetics of the ankle-foot system for individuals with impaired ankle-foot energetics. This study will provide critical understanding of the human foot’s energetics and how energy usage and transfer throughout the ankle and foot can be modulated in both healthy and impaired individuals.This project is jointly funded by the Disability and Rehabilitation Engineering program and the Established Program to Stimulate Competitive Research (EPSCoR).This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.