铰链式踝足矫形器矢状面轴移位对步态力学和轴-腿相对运动的影响

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-04-15 DOI:10.1016/j.clinbiomech.2025.106527

Harald Böhm , Markus Müller , Markus Hildebrandt-Ahlborn , Thomas Schmalz , Malte Bellmann

{"title":"铰链式踝足矫形器矢状面轴移位对步态力学和轴-腿相对运动的影响","authors":"Harald Böhm , Markus Müller , Markus Hildebrandt-Ahlborn , Thomas Schmalz , Malte Bellmann","doi":"10.1016/j.clinbiomech.2025.106527","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The alignment of the axis in ankle-foot orthoses is essential for ensuring optimal biomechanical function and comfort for the user. Correct alignment reduces orthosis displacement, minimizes skin irritation and joint stress, and improves overall performance. This study explores the effects of varying joint axis positions on ankle-foot orthoses functionality and shaft-to-leg movement.</div></div><div><h3>Methods</h3><div>Six healthy adult males (mean age: 35 ± 12 years) participated, walking with bilateral ankle foot orthoses configured in five joint axis positions and a shod condition. A 3D motion analysis system captured kinematic and kinetic data, examining the effects of anterior, posterior, proximal, and distal axis shifts on range of motion, joint moments, energy, and shaft-to-leg relative movement (pistoning).</div></div><div><h3>Findings</h3><div>Anterior-posterior axis shifts significantly affected joint mechanics. Anterior alignment produced the highest dorsiflexion moments and reduced pistoning during dorsiflexion. Range of motion was reduced in all orthotic conditions compared to the shod condition. Proximal-distal shifts had minimal biomechanical impact but increased pistoning. Contrary to expectations, neutral alignment due to the recommendations of the manufacturer did not consistently minimize pistoning or preserve motion.</div></div><div><h3>Interpretation</h3><div>This study underscores the importance of anterior-posterior alignment in optimizing ankle joint function with orthotics. Specifically, anterior alignment reduced pistoning more effectively than the manufacturer-recommended neutral position, particularly during dorsiflexion. These findings highlight the clinical relevance of aligning the orthotic axis with natural joint mechanics, which can reduce motion restrictions, improve gait efficiency, and prevent harmful pressures that may cause discomfort, bruising, and inflammation around the ankle.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"125 ","pages":"Article 106527"},"PeriodicalIF":1.4000,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of sagittal plane axis shifts in hinged ankle-foot orthoses on gait mechanics and shaft-to-leg relative motion\",\"authors\":\"Harald Böhm , Markus Müller , Markus Hildebrandt-Ahlborn , Thomas Schmalz , Malte Bellmann\",\"doi\":\"10.1016/j.clinbiomech.2025.106527\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>The alignment of the axis in ankle-foot orthoses is essential for ensuring optimal biomechanical function and comfort for the user. Correct alignment reduces orthosis displacement, minimizes skin irritation and joint stress, and improves overall performance. This study explores the effects of varying joint axis positions on ankle-foot orthoses functionality and shaft-to-leg movement.</div></div><div><h3>Methods</h3><div>Six healthy adult males (mean age: 35 ± 12 years) participated, walking with bilateral ankle foot orthoses configured in five joint axis positions and a shod condition. A 3D motion analysis system captured kinematic and kinetic data, examining the effects of anterior, posterior, proximal, and distal axis shifts on range of motion, joint moments, energy, and shaft-to-leg relative movement (pistoning).</div></div><div><h3>Findings</h3><div>Anterior-posterior axis shifts significantly affected joint mechanics. Anterior alignment produced the highest dorsiflexion moments and reduced pistoning during dorsiflexion. Range of motion was reduced in all orthotic conditions compared to the shod condition. Proximal-distal shifts had minimal biomechanical impact but increased pistoning. Contrary to expectations, neutral alignment due to the recommendations of the manufacturer did not consistently minimize pistoning or preserve motion.</div></div><div><h3>Interpretation</h3><div>This study underscores the importance of anterior-posterior alignment in optimizing ankle joint function with orthotics. Specifically, anterior alignment reduced pistoning more effectively than the manufacturer-recommended neutral position, particularly during dorsiflexion. These findings highlight the clinical relevance of aligning the orthotic axis with natural joint mechanics, which can reduce motion restrictions, improve gait efficiency, and prevent harmful pressures that may cause discomfort, bruising, and inflammation around the ankle.</div></div>\",\"PeriodicalId\":50992,\"journal\":{\"name\":\"Clinical Biomechanics\",\"volume\":\"125 \",\"pages\":\"Article 106527\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-04-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Biomechanics\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0268003325001007\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Biomechanics","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0268003325001007","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}

引用次数: 0

摘要

踝足矫形器中轴的对齐对于确保最佳的生物力学功能和使用者的舒适度至关重要。正确的对齐减少矫形器位移，最大限度地减少皮肤刺激和关节应力，并提高整体性能。本研究探讨不同关节轴位置对踝关节-足矫形器功能和轴-腿运动的影响。方法6名健康成年男性，平均年龄35±12岁，双侧踝关节足矫形器配置在5个关节轴位置，穿鞋行走。3D运动分析系统捕获运动学和动力学数据，检查前、后、近、远轴位移对运动范围、关节力矩、能量和轴-腿相对运动（活塞）的影响。前后轴移位显著影响关节力学。前位矫正产生最大的背屈力矩和减少背屈时的活塞作用。与穿鞋的情况相比，所有矫形条件下的活动范围都减少了。近端到远端移位的生物力学影响最小，但增加了活塞作用。与预期相反，由于制造商的建议，中性对准并没有始终如一地减少活塞或保持运动。本研究强调了前后对齐在优化矫形器踝关节功能中的重要性。具体来说，前位比制造商推荐的中立位更有效地减少了活塞，特别是在背屈时。这些发现强调了将矫形轴与自然关节力学对齐的临床意义，它可以减少运动限制，提高步态效率，并防止可能导致脚踝周围不适、瘀伤和炎症的有害压力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Effects of sagittal plane axis shifts in hinged ankle-foot orthoses on gait mechanics and shaft-to-leg relative motion

Background

The alignment of the axis in ankle-foot orthoses is essential for ensuring optimal biomechanical function and comfort for the user. Correct alignment reduces orthosis displacement, minimizes skin irritation and joint stress, and improves overall performance. This study explores the effects of varying joint axis positions on ankle-foot orthoses functionality and shaft-to-leg movement.

Methods

Six healthy adult males (mean age: 35 ± 12 years) participated, walking with bilateral ankle foot orthoses configured in five joint axis positions and a shod condition. A 3D motion analysis system captured kinematic and kinetic data, examining the effects of anterior, posterior, proximal, and distal axis shifts on range of motion, joint moments, energy, and shaft-to-leg relative movement (pistoning).

Findings

Anterior-posterior axis shifts significantly affected joint mechanics. Anterior alignment produced the highest dorsiflexion moments and reduced pistoning during dorsiflexion. Range of motion was reduced in all orthotic conditions compared to the shod condition. Proximal-distal shifts had minimal biomechanical impact but increased pistoning. Contrary to expectations, neutral alignment due to the recommendations of the manufacturer did not consistently minimize pistoning or preserve motion.

Interpretation

This study underscores the importance of anterior-posterior alignment in optimizing ankle joint function with orthotics. Specifically, anterior alignment reduced pistoning more effectively than the manufacturer-recommended neutral position, particularly during dorsiflexion. These findings highlight the clinical relevance of aligning the orthotic axis with natural joint mechanics, which can reduce motion restrictions, improve gait efficiency, and prevent harmful pressures that may cause discomfort, bruising, and inflammation around the ankle.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

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.