The effect of soleplate stiffness of an ankle-foot orthosis on the toe-off phase during walking in healthy people.

Kars, H.J.J. (Cojanne) (2009) The effect of soleplate stiffness of an ankle-foot orthosis on the toe-off phase during walking in healthy people. thesis, Human Movement Sciences.

Text Kars.pdf Restricted to Registered users only Download (10MB)

Abstract

Introduction: A common therapeutic approach to improve the walking ability of stroke patients is the prescription of an ankle-foot orthosis (AFO). Several designs of AFOs are available for stroke patients, but AFOs are designed with pre-positioning of the heel in mind, while the influence of the AFO on the third rocker of the gait has largely been ignored. In this study the focus is on the stiffness of the soleplate of the AFO and its effect on the toe-off phase at two different walking velocities. Methods: A randomized crossover trial was used to study the effects of the soleplate stiffness of an AFO on the toe-off in healthy people. The healthy volunteers walked at 2 different velocities (selfselected velocity and at 0.5m/s) wearing standardized shoes, in a random order. Walking with 'shoesonly' formed the control condition and walking with each of the four AFOs created the intervention conditions. The primary outcome measure was the vertical ground reaction force (GRF). To analyse both kinematic and kinetic data a total of 14 parameters were assessed. Results: No statistical significance difference between GRF, knee and hip angles, and ankle moment existed between the different conditions at either walking velocity. There was a statistically significant delay in the timing of the plantarflexion movement during heel strike of all the AFO conditions compared with the shoes-only condition when walking at a slow velocity and between shoes-only and AF02, AF03, and AFO 4 when walking at a self-selected velocity. At either velocity there was no differences between the AFOs. The plantarflexion movement at toe-off was significantly decreased in all the AFO conditions compared with to shoes-only at either velocity, again with no differences between the AFOs. Conclusion: There was a lack of difference between the AFOs on different gait characteristics of the healthy volunteers. The AFOs decreased the plantarflexion movement during toe-off but this did not have an effect on the vertical GRF during the forefoot rocker, which means that the soleplate stiffness could support the vertical GRF, or there must be a compensation strategy available to overcome the mechanical constraints imposed by the AFO.

Item Type:	Thesis (Thesis)
Supervisor name:	Otten, Prof. Dr. Bert
Supervisor name:	Nester, Prof. Dr. Chris and Tyson, Dr. Sarah and University of Salford
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:02
Last Modified:	25 Jun 2020 11:02
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2207

Actions (login required)

View Item