Improving mobility in peripheral artery disease using an ankle foot orthosis

外周动脉疾病(PAD)是系统性动脉粥样硬化的一种表现， 以供应腿部的动脉发生动脉粥样硬化阻塞为特征。 跛行，定义为步行引起的步态障碍和肌肉疼痛，是最常见的 PAD的常见表现。5%的55岁以上的美国人行动不便 几年前。克劳迪斯患者行动不便，身体不适 功能不良，健康状况不佳，摔倒的风险增加。在我们的研究中 实验室已经记录了脚踝足底屈肌产生的严重缺陷 行走时扭矩和功率正常。此外，PAD患者的患肢 表现出妨碍正常肌肉功能的肌肉肌病。在受监督期间 运动可以有效地增加PAD患者的步行距离，但它不是 产生脚踝趾屈肌力矩，或减少腿部肌肉的压力。脚踝- 足底矫形器(AFO)是一种由碳复合材料制成的可以抵消脚踝的装置 足屈肌扭矩和功率，减少血流需求和肌肉应力 在走路的时候。碳复合材料AFO的弹簧式特性允许能量 在重量验收时储存，并在脚趾离开时返回。我们的试点工作已经表明 与AFO一起行走会立即增加初始和绝对步行 PAD患者的治疗距离与药物治疗一样长达6个月。本研究 将确定AFO是否可以改善PAD患者的步行能力 它是第一次使用。此外，这项研究还将测试三个月AFO后的行走能力 我们还将研究AFO这一干预措施的可行性。中环 假说是AFO可以立即改善步行能力 步行的能量成本。三个月后步行能力的改善 由于肌肉的改善，预计干预措施比第一次使用的干预更大 患者患肢的功能。与之相关的机制的详细措施 步行能力、肌肉贡献、体力活动、生活质量以及这些因素 AFO佩戴三个月后机制变化将提供证据 需要实施AFO疗法，以改善功能状态和质量 在个人生活中有PAD。

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.