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

脚和脚踝在有效行走的能力中起着重要作用，而有效行走对独立生活和整体生活质量至关重要。然而，脚在行走效率中的作用还没有被很好地理解，这限制了未来辅助设备的创新。这对力量受损的患者和脚踝行走辅助设备的设计具有重要意义。这项研究旨在揭示控制足部能量的机制，并将这一新的理解应用于使用新型脚托帮助踝足损伤患者行走。预计从这项工作中获得的知识将促使人们对脚在行走中的作用的理解发生转变，这将应用于下一代脚和脚踝-脚辅助装置的设计。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。这项研究的目的是揭示控制人类足部能量的机制的批判性理解，并应用这些理解来探索和调节使用新型足部矫形器的脚踝-足部系统的能量。这一目标将通过三个部分实现。首先，将通过一系列活动系统地操控趾趾关节运动，并将通过新颖的运动学、多节段足部模型来研究足部力量和功的相关变化。这将提供如何在健康的踝足系统中使用和转移能量的关键知识，并增强解释用于捕获和量化足部能量的测量结果的能力。接下来，我们将使用一种具有定制前脚硬度的新型可变形足部矫形器来探索脚踝-足部能量的使用和转移，以更深入地了解健康足部的能量以及它与脚踝关节的相互作用。健康的人将在鞋类条件下行走，代表不同的前脚僵硬水平，同时收集能量和生物力学运动分析数据。最后，作为一项可行性证明研究，中风后的个体将在三种条件下行走-赤脚、灵活的鞋子和定制的前脚僵硬矫形器-同时收集能量和生物力学运动捕捉数据。这个最终目标的目的是确定是否可以使用具有定制前脚僵硬的可变形足部矫形器来增强踝足系统的能量，以帮助踝足能量受损的个人。这项研究将提供对人类足部能量学的批判性理解，以及如何在健康和受损个体中调节脚踝和足部的能量使用和转移。该项目由残疾和康复工程计划和既定的激励竞争研究计划(EPSCoR)联合资助。该奖项反映了NSF的法定使命，并通过使用基金会的智力优势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.