Journal article
The impact of ankle-foot orthosis stiffness on gait: A systematic literature review
Gait & posture, Vol.69, pp.101-111
03/2019
DOI: 10.1016/j.gaitpost.2019.01.020
PMID: 30708092
Abstract
•Altering AFO stiffness affected ankle and knee kinematics, but not kinetics.•Changes in AFO stiffness did not affect hip kinematics or kinetics.•Studies tested AFO stiffness in the range of 0–8 Nm/deg.•Studies measured stiffness differently, and many do not report stiffness values.•There is insufficient data to identify the AFO stiffness ranges that affect gait.
Ankle-foot orthoses (AFOs) are commonly prescribed to provide ankle support during walking. Current prescription standards provide general guidelines for choosing between AFO types, but are limited in terms of guiding specific design parameter choices. These design parameters affect the ankle stiffness of the AFO.
The aim of this review was to investigate the impact of AFO stiffness on walking mechanics.
A literature search was conducted using three databases: Pubmed, Engineering Village, and Web of Science.
After applying the exclusion criteria, 25 of 287 potential articles were included. The included papers tested a range of stiffnesses (0.02–8.17 Nm/deg), a variety of populations (e.g. healthy, post-stroke, cerebral palsy) and various gait outcome measures. Ankle kinematics were the most frequently reported measures and the most consistently affected by stiffness variations. Greater stiffnesses generally resulted in reduced peak ankle plantarflexion, dorsiflexion, and total range of motion, as well as increased dorsiflexion at initial contact. At the knee, a few studies reported increased flexion at initial contact, and decreased peak extension and increased peak flexion during stance when stiffness was increased. Stiffness did not affect hip kinetics and there was low evidence for its effects on hip or pelvis kinematics, ankle and knee kinetics, muscle activity, metabolic cost, ground reaction forces and spatiotemporal parameters. There were no generalizable trends for the impact of stiffness on user preference.
AFO stiffness is a key factor influencing ankle movement. Clear reporting standards for AFO design parameters, as well as additional high quality research is needed with larger sample sizes and different clinical populations to ascertain the true effect of stiffness on gait.
Details
- Title: Subtitle
- The impact of ankle-foot orthosis stiffness on gait: A systematic literature review
- Creators
- Deema Totah - University of Michigan–Ann ArborMeghna Menon - University of Michigan–Ann ArborCarlie Jones-Hershinow - University of Michigan–Ann ArborKira Barton - University of Michigan–Ann ArborDeanna H Gates - University of Michigan–Ann Arbor
- Resource Type
- Journal article
- Publication Details
- Gait & posture, Vol.69, pp.101-111
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.gaitpost.2019.01.020
- PMID
- 30708092
- ISSN
- 0966-6362
- eISSN
- 1879-2219
- Grant note
- DOI: 10.13039/100000001, name: National Science Foundation, award: 1534003
- Language
- English
- Date published
- 03/2019
- Academic Unit
- Mechanical Engineering
- Record Identifier
- 9984196558102771
Metrics
25 Record Views