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Improving mobility in peripheral artery disease using an ankle foot orthosis

使用踝足矫形器改善外周动脉疾病的活动能力

基本信息

批准号：
9976549
负责人：
Sara A Myers
金额：
$ 40.81万
依托单位：
UNIVERSITY OF NEBRASKA OMAHA
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-23 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9976549
关键词：
Address Affect Age-Years American Ankle Arteries Atherosclerosis Biomechanics Blood flow Carbon Cardiovascular Diseases Characteristics Crossover Design Devices Disease Ensure Exercise Failure Foot-drop Functional disorder Gait Gastrocnemius Muscle Health Individual Intermittent Claudication Intervention Ischemia Kinetics Laboratories Leg Limb structure Long-Term Effects Measurement Measures Motivation Muscle Muscle Cramp Muscle function Myalgia Myopathy Neuromuscular Diseases Orthotic Devices Outcome Oxygen Pain Pain in lower limb Participant Patients Performance Peripheral arterial disease Pharmacotherapy Physical Function Physical activity Property Quality of life Reporting Research Resources Rest Stress Stroke Supervision Symptoms Target Populations Testing Time Toes Torque Walking Weight Work claudication cost effective therapy experience fall risk foot functional status hemodynamics improved improved functioning improved mobility mechanical force muscle strength novel strategies preservation prevent satisfaction sedentary success treadmill treatment planning

项目摘要

Peripheral artery disease (PAD) is a manifestation of systemic atherosclerosis, characterized by atherosclerotic blockages of the arteries supplying the legs. Claudication, defined as walking induced gait dysfunction and muscle pain, is the most common manifestation of PAD. Claudication affects 5% of Americans older than 55 years of age. Claudicating patients experience reduced mobility, reduced physical functioning, poor health outcomes, and increased risk for falls. Research in our laboratory has documented significant deficits in the ankle plantarflexors to generate normal torque and power during walking. Further, affected legs of patients with PAD demonstrate a muscle myopathy that prevents normal muscle function. While supervised exercise is effective for increasing the distance patients with PAD can walk, it does not generate ankle plantarflexor torque, or decrease stress on the leg muscles. An ankle- foot orthosis (AFO) is a device made of carbon-composite material that can offset ankle plantarflexor torque and power and decrease blood flow demand and muscular stress during walking. The spring-like properties of carbon composite AFOs allow energy storage at weight acceptance and return at the point of toe off. Our pilot work has shown that walking with an AFO immediately increases the initial and absolute walking distances in patients with PAD as much as pharmacotherapy for six months. This study will determine whether an AFO improves walking performance in patients with PAD from its first use. Additionally, the study will test walking performance after a three month AFO intervention and will examine the feasibility of this AFO intervention. The central hypothesis is that the AFO immediately improves walking performance by decreasing the energy cost of walking. Walking performance improvement following the three-month intervention is expected to be larger than that of first use due to improving the muscular function of patients' affected legs. Detailed measures of mechanisms related with walking performance, muscle contribution, physical activity, quality of life and how these mechanisms change after wearing the AFO for three months will provide the evidence required to implement an AFO therapy that will improve functional status and quality of life in individuals with PAD.

外周动脉疾病（PAD）是系统性动脉粥样硬化的一种表现，