Development of an ankle-foot orthosis that provides support for flaccid paretic plantarflexor and dorsiflexor muscles

Dymphy Van Der Wilk* (Corresponding Author), Roy Reints, Klaas Postema, Tom Gort, Jaap Harlaar, Juha Markus Hijmans, Gijsbertus Jacob Verkerke

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)

Abstract

ADJUST, a novel ankle-foot orthosis (AFO) that we have developed, allows the ankle a normal range of motion (ROM) while providing support for flaccid ankle-muscle paresis. It consists of two leaf-spring hinges that independently control plantarflexion and dorsiflexion stiffness. To evaluate whether ADJUST meets the minimum mechanical requirements, we quantified its ankle ROM and stiffness. To evaluate whether it meets the minimum ankle kinematic and kinetic goals for normal gait, a patient with both plantarflexor and dorsiflexor paralysis used it, and his own AFO, to walk. When fitted with stiff springs, ADJUST met all requirements and goals. During the stance and the swing phases, ankle ROM was within the normal range when ADJUST was fitted with stiff springs. Ankle ROM during stance was outside the normal range both with the patient's own AFO and with ADJUST when it was fitted with flexible springs. Power at the ankle met the minimum goal but was lower with ADJUST than with the patient's own AFO. The optimal stiffness configuration that would result in a higher power at the ankle with a normal ankle ROM was not reached for this patient. Walking with ADJUST seems feasible and could be profitable in patients with flaccid ankle muscle paresis.

Original languageEnglish
Pages (from-to)1036-1045
Number of pages10
JournalIEEE transactions on neural systems and rehabilitation engineering
Volume26
Issue number5
DOIs
Publication statusPublished - 1 May 2018
Externally publishedYes

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Keywords

  • Ankle foot orthosis
  • ankle muscle paresis
  • ankle range of motion
  • patient-centered

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