Adaptation of functional gait parameters to a newly provided stiffness-optimized ankle-foot orthosis

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-01 DOI:10.1016/j.clinbiomech.2024.106428

Elza van Duijnhoven , Katinka van der Kooij , Esther Vlot , Merel-Anne Brehm , Niels F.J. Waterval

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引用次数: 0

Abstract

Background

Clinical decisions regarding ankle-foot-orthosis stiffness in people with calf muscle weakness are based on immediate evaluations, not taking gait adaptation into account. This study examined adaptation of step length, walking speed and energy cost of walking in the 3-months post-provision and whether individuals with higher gait variability adapt more compared to individuals with lower gait variability.

Methods

We conducted a post-hoc analysis in eighteen stiffness-optimized ankle-foot-orthosis users with bilateral calf muscle weakness. Gait biomechanics, step length, walking speed and walking energy cost directly after provision (T1) and 3-months post-provision of the ankle-foot-orthosis (T2) were compared using paired sampled t-tests. Based on gait variability scores at T1, a high and low gait variability group was determined, and change scores in the functional gait parameters were compared using non-parametric independent sampled t-tests. A significance level of p ˂ 0.1 was used.

Findings

No significant differences in step length, walking speed and energy cost of walking between T1 and T2 were found (p > 0.20). Step length increased more in people with high gait variability scores at T1 compared to those with low gait variability scores (High: +3.1 [−3.2 − +6.9], Low: +0.2 [−6.8 − +3.7] cm, p = 0.085), while no differences between groups were found for walking speed and energy cost of walking (p > 0.129).

Interpretation

After provision of stiffness-optimized ankle-foot-orthoses in people with bilateral calf muscle weakness, no functional gait adaptations were found. However, people demonstrating high gait variability increased step length more compared to those demonstrating lower variability, which might be an indication that variability plays a role in adaptation.

查看原文本刊更多论文

功能步态参数适应新提供的刚度优化踝关节-足矫形器。

背景：对于小腿肌无力患者的踝关节-足矫形器僵硬的临床决定是基于即时评估，而不是考虑步态适应。本研究考察了喂养后3个月的步长、步行速度和步行能量消耗的适应性，以及步态变异性较高的个体是否比步态变异性较低的个体更能适应。方法：我们对18例双侧小腿肌肉无力的刚度优化踝关节-足矫形器使用者进行了事后分析。采用配对抽样t检验比较提供后（T1）和提供后3个月踝关节-足部矫形器（T2）的步态生物力学、步长、步行速度和步行能量成本。根据T1时的步态变异性评分，确定高、低步态变异性组，并采用非参数独立抽样t检验比较功能步态参数的变化评分。显著性水平为p小于0.1。结果：T1和T2在步长、步行速度和步行能量消耗方面无显著差异（p < 0.20）。步态变异性得分高的人在T1时的步长比步态变异性得分低的人增加得更多（高：+3.1[-3.2 - +6.9]，低：+0.2 [-6.8 - +3.7]cm, p = 0.085），而两组之间在步行速度和步行能量消耗方面没有差异（p > 0.129）。解释：在为双侧小腿肌肉无力的患者提供刚度优化的踝关节-足矫形器后，没有发现功能性步态适应。然而，表现出高步态变异性的人比表现出低步态变异性的人增加的步长更多，这可能表明变异性在适应中起着作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.