1,786 results match your criteria ankle-foot orthoses

Malunited and malrotated Salter-Harris type I fracture of distal femur managed with circular ring external Ilizarov fixator.

BMJ Case Rep 2021 Jun 9;14(6). Epub 2021 Jun 9.

Orthopedics & Spine Surgery, Ghurki Trust Teaching Hospital, Lahore, Pakistan

A 9-year-old girl presented with malunited Salter-Harris type I fracture of distal femur treated by bone-setter (unreliable-practitioner). Assessment revealed 3 cm limb-length-discrepancy and affected leg was unable to bear weight, knee was stiff with no active-range of motion; radiographs showed displaced sagittally malunited femoral condyle with 163° posterior distal femoral angle (PDFA). Correction planned with circular-ring-external Ilizarov fixator using distraction-osteogenesis through supracondylar osteotomy and gradual anterior opening. Read More

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Effects of Orthoses on Standing Postural Control and Muscle Activity in Children With Cerebral Palsy.

Pediatr Phys Ther 2021 Jun 7. Epub 2021 Jun 7.

Early Intervention Associates (Dr Leonard), Rockville, Maryland; Doctoral Programs in Pediatric Science (Dr Sweeney), Rocky Mountain University of Health Professions, Provo, Utah; Functional and Applied Biomechanical Lab at National Institutes of Health (Dr Damiano), NIH Bethesda, Maryland; School of Medicine (Dr Bjornson), University of Washington, Seattle, Washington; Marymount University Program in Physical Therapy (Dr Ries), Marymount University, Arlington, Virginia.

Purpose: This exploratory study assessed postural control and muscle activity in children with cerebral palsy while standing barefoot (BF), in prescribed ankle-foot orthoses (AFOs) and in distal control orthoses (DCOs), which stabilized foot-ankle and deliberately aligned the shank.

Methods: This within-subject study evaluated 10 participants, Gross Motor Functional Classification System level III, across the 3 ankle-foot conditions in: (1) static standing duration and (2) modified Clinical Test of Sensory Interaction on Balance with electromyography (EMG) on 7 muscles.

Results: Participants had significantly decreased center of gravity (COG) velocity sway in DCO versus BF and AFO, decreased loss of balance (LOB), and increased standing for DCO versus BF. Read More

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Individual stiffness optimization of dorsal leaf spring ankle-foot orthoses in people with calf muscle weakness is superior to standard bodyweight-based recommendations.

J Neuroeng Rehabil 2021 Jun 8;18(1):97. Epub 2021 Jun 8.

Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.

Background: In people with calf muscle weakness, the stiffness of dorsal leaf spring ankle-foot orthoses (DLS-AFO) needs to be individualized to maximize its effect on walking. Orthotic suppliers may recommend a certain stiffness based on body weight and activity level. However, it is unknown whether these recommendations are sufficient to yield the optimal stiffness for the individual. Read More

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Effect of Ankle Torque on the Ankle-Foot Orthosis Joint Design Sustainability.

Materials (Basel) 2021 May 31;14(11). Epub 2021 May 31.

Department of Mechanical Engineering, Inha University, 100 Inha-ro, Michuhol-gu, Incheon 22212, Korea.

The ankle joint of a powered ankle-foot orthosis (PAFO) is a prominent component, as it must withstand the dynamic loading conditions during its service time, while delivering all the functional requirements such as reducing the metabolic effort during walking, minimizing the stress on the user's joint, and improving the gait stability of the impaired subjects. More often, the life of an AFO is limited by the performance of its joint; hence, a careful design consideration and material selection are required to increase the AFO's service life. In the present work, a compact AFO joint was designed based on a worm gear mechanism with steel and brass counterparts due to the fact of its large torque transfer capability in a single stage, enabling a compact joint. Read More

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Shortcomings of human-in-the-loop optimization of an ankle-foot prosthesis emulator: a case series.

R Soc Open Sci 2021 May 5;8(5):202020. Epub 2021 May 5.

Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA.

Human-in-the-loop optimization allows for individualized device control based on measured human performance. This technique has been used to produce large reductions in energy expenditure during walking with exoskeletons but has not yet been applied to prosthetic devices. In this series of case studies, we applied human-in-the-loop optimization to the control of an active ankle-foot prosthesis used by participants with unilateral transtibial amputation. Read More

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The effect of rotational speed on ankle-foot orthosis properties.

J Biomech 2021 May 1;123:110483. Epub 2021 May 1.

School of Kinesiology, University of Michigan, Ann Arbor, MI, USA. Electronic address:

Ankle-foot orthoses (AFOs) are devices that support ankle motion. An AFO's sagittal plane rotational stiffness can affect gait kinematics. Because AFOs are often made from viscoelastic materials, their properties may vary at different walking speeds. Read More

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[Kinematic gait pattern with silicone ankle-foot ortesis in patients with drop foot].

Acta Ortop Mex 2020 Nov-Dec;34(6):371-375

Universidad San Pablo CEU, Madrid. España.

Introduction: The Drop foot is a condition that is usually handled with short orthosis, usually made of polypropylene. It has also been described as being treated with silicon orthosis, little studied but which seem to improve the kinematic pattern of gait and, given its comfort, be more accepted by patients. Our study describes the kinematic characteristics of gait and patient satisfaction when using a silicon foot ankle orthosis, and compares this pattern to the non-use of the orthosis, in patients with a drop foot. Read More

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Effects of age and locomotor demand on foot mechanics during walking.

J Biomech 2021 May 7;123:110499. Epub 2021 May 7.

Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA.

Older adults exhibit reductions in push-off power that are often attributed to deficits in plantarflexor force-generating capacity. However, growing evidence suggests that the foot may also contribute to push-off power during walking. Thus, age-related changes in foot structure and function may contribute to altered foot mechanics and ultimately reduced push-off power. Read More

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The diagnostic, therapeutic and assistance pathway for amyotrophic lateral sclerosis in a north-eastern Italian region: satisfaction of patients and their caregivers.

Health Soc Care Community 2021 May 20. Epub 2021 May 20.

Neurology Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, ASUFC, Udine, Italy.

In order to evaluate the users' satisfaction degree for the diagnostic, therapeutic and assistance services for amyotrophic lateral sclerosis (ALS) in the Italian region Friuli-Venezia Giulia (FVG), a self-compiled anonymous multiple-choice questionnaire was administered to ALS patients and their caregivers. The questionnaire explored 41 different issues covering the following areas: (a) access to diagnostic pathway and communication among patients, families and health professionals; (b) quality of disease monitoring and effectiveness of interventions aimed at mitigating ALS symptoms; (c) easiness of access to assistive devices (e.g. Read More

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Role of the newly designed Ankle Foot Orthosis on balance related parametersin drop foot post stroke patients.

J Bodyw Mov Ther 2021 Apr 21;26:501-504. Epub 2020 Nov 21.

Rehabilitation Research Center Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Passive and hybrid passive ankle foot orthoses (AFOs) are often prescribed in post stroke drop foot; however, the effects of these AFOs on balance related parameters in these patients seem unclear. Accordingly, the aim of current study was to evaluate the role of the newly designed hybrid passive and Posterior Leaf Spring (PLS) AFOs on balance related parameters including: self-reported balance confidence (ABC), Timed Up and Go Test (TUG) and Berg Balance Scale (BBS) in post stroke drop foot patients.

Methods: Fifteen post stroke drop foot patients were recruited in current study. Read More

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Generating an Adaptive and Robust Walking Pattern for a Prosthetic Ankle-Foot by Utilizing a Nonlinear Autoregressive Network With Exogenous Inputs.

IEEE Trans Neural Netw Learn Syst 2021 May 12;PP. Epub 2021 May 12.

One of the major challenges in developing powered lower limb prostheses is emulating the behavior of an intact lower limb with different walking speeds over diverse terrains. Numerous studies have been conducted on control algorithms in the field of rehabilitation robotics to achieve this overarching goal. Recent studies on powered prostheses have frequently used a hierarchical control scheme consisting of three control levels. Read More

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Differences in lower-extremity kinematics between the male military personnel with and without plantar fasciitis.

Phys Ther Sport 2021 Apr 30;50:130-137. Epub 2021 Apr 30.

Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand. Electronic address:

Objective: To evaluate the factors that influence gait by comparing lower extremity kinematics during the stance phase of the gait cycle between individuals with and without plantar fasciitis.

Design: A cross-sectional study.

Setting: Motion analysis research laboratory. Read More

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Neuromechanics and Energetics of Walking With an Ankle Exoskeleton Using Neuromuscular-Model Based Control: A Parameter Study.

Front Bioeng Biotechnol 2021 9;9:615358. Epub 2021 Apr 9.

George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, United States.

Powered ankle exoskeletons that apply assistive torques with optimized timing and magnitude can reduce metabolic cost by ∼10% compared to normal walking. However, finding individualized optimal control parameters is time consuming and must be done independently for different walking modes (e.g. Read More

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Effect of ankle joint fixation on tibialis anterior muscle activity during split-belt treadmill walking in healthy subjects: A pilot study.

Turk J Phys Med Rehabil 2021 Mar 4;67(1):11-16. Epub 2021 Mar 4.

Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan.

Objectives: This study aims to examine the characteristics of muscle activity change of the tibialis anterior (TA) muscle in healthy adults while they walked on a split-belt treadmill with one fixed ankle.

Patients And Methods: This randomized controlled trial was conducted between November 2017 and July 2018. Fourteen healthy male individuals (mean age 31. Read More

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Knee joint movement and muscle activity changes in stroke hemiplegic patients on continuous use of knee-ankle-foot orthosis with adjustable knee joint.

Minoru Murayama

J Phys Ther Sci 2021 Apr 6;33(4):322-328. Epub 2021 Apr 6.

Funabashi Municipal Rehabilitation Hospital: 4-26-1 Natsumidai, Funabashi, Chiba 273-0866, Japan.

[Purpose] We aimed to evaluate knee joint movement and muscle activity ratio changes in stroke hemiplegic patients in recovery phase after using a knee-ankle-foot orthosis with an adjustable knee joint for 1 month; we also aimed to discuss the practical implications of our findings. [Participants and Methods] The participants were 8 hemiplegic patients in the recovery phase of stroke who were prescribed knee-ankle-foot orthosis with adjustable knee joint. We measured knee joint angles and electromyographic activity of the vastus medialis and biceps femoris during walking in two conditions: the knee-ankle-foot orthosis knee joint fixed in the extended position and the knee joint moved from 0° to 30° in the flexion direction. Read More

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Lumbosacral plexopathy due to pelvic hematoma after extracorporeal membrane oxygenation: A case report.

Medicine (Baltimore) 2021 Apr;100(17):e25698

Department of Neurology, Washington University School of Medicine, Saint Louis, MO.

Rationale: Peripheral nerve injury related to vascular complications associated with extracorporeal membrane oxygenation (ECMO) is perhaps underappreciated. Compared to the well-described central nervous system complications of ECMO, brachial plexopathy and lumbosacral plexopathy have rarely been reported. We report this case to heighten awareness of lumbosacral plexus injury due to pelvic hematoma formation after ECMO. Read More

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[Biomechanical analysis of ankle-foot complex during a typical Tai Chi movement-Brush Knee and Twist Step].

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2021 Feb;38(1):97-104

Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, P.R.China.

The purpose of this study is to analyze the biomechanics of ankle cartilage and ligaments during a typical Tai Chi movement-Brush Knee and Twist Step (BKTS). The kinematic and kinetic data were acquired in one experienced male Tai Chi practitioner while performing BKTS and in normal walking. The measured parameters were used as loading and boundary conditions for further finite element analysis. Read More

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February 2021

Management of gait impairments in people with Charcot-Marie-Tooth disease: A treatment algorithm.

J Rehabil Med 2021 May 21;53(5):jrm00194. Epub 2021 May 21.

Department of Rehabilitation, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, 6541GX Nijmegen, The Netherlands. E-mail:

Gait impairments in people with Charcot Marie Tooths disease are the combined result of ankle-foot deformities, muscle weakness, and somatosensory impairments. People with Charcot-Marie-Tooth disease often experience pain and difficulties when walking, especially barefoot. They also trip and fall frequently and have a lower than normal gait speed and distance. Read More

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Machine learning analysis to predict the need for ankle foot orthosis in patients with stroke.

Sci Rep 2021 Apr 19;11(1):8499. Epub 2021 Apr 19.

Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunghwndo-ro, Dong-gu, Ulsan, 44033, Republic of Korea.

We investigated the potential of machine learning techniques, at an early stage after stroke, to predict the need for ankle-foot orthosis (AFO) in stroke patients. We retrospectively recruited 474 consecutive stroke patients. The need for AFO during ambulation (output variable) was classified according to the Medical Research Council (MRC) score for the ankle dorsiflexor of the affected limb. Read More

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The Codivilla Spring: from then to now and beyond.

Eur J Phys Rehabil Med 2021 Apr 16. Epub 2021 Apr 16.

Physical Medicine and Rehabilitation Unit, IRCCS-Istituto Ortopedico Rizzoli, Bologna, Italy -

The ankle-foot-orthosis (AFO), originally called Codivilla Spring, is an orthotic device prescribed to the patients with foot drop due to neurological diseases in order to control the range of motion of the ankle joint, to compensate for the muscle weakness/spasticity thus optimizing the gait function. In this paper, a historical revision of the most known and used AFO worldwide from the origin of its name and the first applications at the Rizzoli Orthopedic Institute to the most advanced solutions in use today is covered. Through the critical analysis of historical documents available, the paper reports on the controversy about the true inventor of the Codivilla Spring during the first decades of the twentieth century. Read More

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Recurvatum of the Knee in Cerebral Palsy: A Review.

David A Yngve

Cureus 2021 Apr 10;13(4):e14408. Epub 2021 Apr 10.

Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston, USA.

Recurvatum is defined as hyperextension of the knee in the stance phase of gait. Recurvatum knee is a naturally occurring common gait deviation in those with cerebral palsy, along with crouch knee, jump knee, and stiff knee gaits. Early and late recurvatum occur in the first and second halves of stance. Read More

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A systematic review of health economic evaluation in orthotics and prosthetics: Part 2-orthotics.

Prosthet Orthot Int 2021 Jun;45(3):221-234

Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.

Background: Health economic evaluations (HEEs) in orthotics are in their infancy. Identification of evidence gaps and method design issues will inform the design of future HEEs that advance knowledge and contributes to policy and investment decisions.

Objectives: The aim of this systematic review was to critically appraise the existing orthotic/prosthetic health economic evaluation literature and therefore determine evidence gaps, critical method design issues, and the extent to which the literature informs orthotic policy and investment decisions. Read More

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Pediatric and adolescent Lisfranc injuries - Presentation, treatment and outcomes.

Foot (Edinb) 2021 Mar 9;46:101737. Epub 2020 Sep 9.

Texas Children's Hospital, 6701 Fannin St., Houston, TX 77030, USA; Department of Orthopedic Surgery, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA.

Purpose: Lisfranc fracture dislocations are rare injuries and even more so in the pediatric population. The main purpose of our study is to present a descriptive analysis of Lisfranc injuries in pediatric patients to add to the current sparse literature on this topic. In addition, our secondary outcome was to analyze any differences in patients treated conservatively versus operatively, and those with isolated Lisfranc injuries versus those with associated foot injuries. Read More

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Postoperative changes in vertical ground reaction forces, walking barefoot and with ankle-foot orthoses in children with Cerebral Palsy.

Clin Biomech (Bristol, Avon) 2021 Apr 23;84:105336. Epub 2021 Mar 23.

Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway; Division of Orthopaedic Surgery, Department of Research, Oslo University Hospital, Oslo, Norway.

Background: Children with cerebral palsy often have problems to support the body centre of mass, seen as increased ratio between excessive vertical ground reaction forces during weight acceptance and decreased forces below bodyweight in late stance. We aimed to examine whether increasing ankle range of motion through surgery and restraining motion with ankle-foot orthoses postoperatively would have impact on the vertical ground reaction force in weight acceptance and late stance.

Methods: Ground reaction forces were recorded from 24 children with bilateral and 32 children with unilateral cerebral palsy, each measured walking barefoot before and after triceps surae lengthening. Read More

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Understanding the effects of quantitatively prescribing passive-dynamic ankle-foot orthosis bending stiffness for individuals after stroke.

Prosthet Orthot Int 2021 Apr 13. Epub 2021 Apr 13.

University of Delaware, Newark, DE.

Background: Passive-dynamic ankle-foot orthosis (PD-AFO) bending stiffness, which assists plantar flexor function, can be prescribed to improve poststroke gait. However, outcomes with PD-AFOs are variable likely because of improper personalization. We implemented a prescription model that objectively personalizes PD-AFO bending stiffness based on each individual's level of plantar flexor weakness (quantitatively prescribed PD-AFO). Read More

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Impacts of Rehabilitation Gait Training on Functional Outcomes after Tibial Nerve Transfer for Patients with Peroneal Nerve Injury: A Nonrandomized Controlled Trial.

Plast Reconstr Surg 2021 May;147(5):1202-1207

From the Department of Surgery, Division of Plastic Surgery, and the Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Alberta.

Background: Although there was initial success using tibial nerve transfer to restore ankle dorsiflexion following peroneal nerve injury, results from later series were less promising. A potential reason is coactivation of the much stronger antagonistic muscles during gait. The purpose of this study was to test the hypothesis that gait training would improve functional performance following tibial nerve transfer. Read More

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Content analysis of child user and carer perspectives of ankle-foot orthoses.

Prosthet Orthot Int 2021 Feb;45(1):12-19

1School of Architecture, Design and Planning, The University of Sydney, Sydney, NSW, Australia 2EPIC Lab, The Children's Hospital at Westmead, Sydney, NSW, Australia 3University of Sydney School of Health Sciences & Children's Hospital at Westmead, Westmead, Sydney, NSW, 2145, Australia.

Background: The evaluation of ankle-foot orthoses is primarily focused on biomechanical performance, with comparatively less studies pertaining to users' quality of life and experiential factors.

Objectives: To investigate how child users regard acquisition and use of ankle-foot orthoses through the perspectives of child users, parents/carers and practitioners.

Study Design: Inductive content analysis of secondary data. Read More

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February 2021

The prediction of need of using ankle-foot orthoses in stroke patients based on findings of a transcranial magnetic stimulation study.

J Integr Neurosci 2021 Mar;20(1):119-123

Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, 41020 Daegu, Republic of Korea.

Ankle-foot orthoses (AFOs) are widely prescribed for stroke rehabilitation. We investigated the potential of transcranial magnetic stimulation (TMS) at an early stage, after stroke, to predict the need of using AFOs in stroke patients. We recruited 35 patients who could walk with intermittent support of one person or independently 3 months after onset of stroke. Read More

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The comparison of the effect of innovative designed storing-restoring hybrid passive AFO versus posterior leaf spring AFO on ankle joint kinematic in drop foot patients: A case series using a single subject design.

Med J Islam Repub Iran 2020 21;34:173. Epub 2020 Dec 21.

Department of Orthotics & Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

Drop foot syndrome is a disorder characterized by foot slapping after the initial contact and foot-dragging during the swing phase. Passive and hybrid passive ankle foot orthoses (AFOs) are often prescribed in these patients; however, the effects of these AFO designs on kinematic parameters during gait are unclear. The aim of this study was to compare the effect of innovative designed storing-restoring hybrid passive AFOs versus posterior leaf spring AFO on ankle joint kinematics in drop foot patients. Read More

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December 2020