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Passive-dynamic ankle-foot orthoses change post-stroke lower extremity constituent work profile
Journal article   Peer reviewed

Passive-dynamic ankle-foot orthoses change post-stroke lower extremity constituent work profile

Jacob T. Skigen, Corey A. Koller, Darcy S. Reisman, Zahra N. McKee, Shay R. Pinhey, Jason M. Wilken and Elisa S. Arch
Journal of biomechanics, Vol.177, 112414
12/2024
DOI: 10.1016/j.jbiomech.2024.112414
PMID: 39514985

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Abstract

Stiffness-customized passive-dynamic ankle–foot orthoses (PD-AFOs) have been shown to reduce the mechanical cost of transport (COT) of individuals post-stroke. However, the mechanisms underlying this reduced COT are unknown. Therefore, this study aimed to identify the factors driving COT reduction with PD-AFO use for individuals post-stroke. Results showed that changes in limb work were strongly correlated to changes in COT with the PD-AFO compared to No AFO in the paretic (tau = 0.637, p < 0.001) and non-paretic (tau = 0.621, p < 0.001) limbs. There was also a strong correlation between changes in limb work and changes in COT compared to SOC AFO in the paretic (tau = 0.569, p < 0.001) and non-paretic (tau = 0.503, p = 0.003) limbs. Conversely, changes in stride length and changes in COT were not correlated. Changes in COT between No AFO and PD-AFO were moderately correlated to the number of constituents that performed less mechanical work for both the paretic (tau = −0.462, p = 0.009) and non-paretic (tau = −0.402, p = 0.025) limbs. Compared to walking with SOC AFOs, there was a moderate correlation between COT and the number of constituents in the paretic limb (tau = −0.458, p = 0.011) but not the non-paretic limb (tau = −0.247, p = 0.173). These findings indicate that PD-AFOs reduce COT primarily through small changes in work across many lower limb constituents. Understanding how COT reduction occurs can help optimize PD-AFO design and possibly other rehabilitation interventions for individuals post-stroke.
Stroke Ankle-Foot Orthosis Cost of Transport Gait Joint Work

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