ArticlesImmediate and long-term effects of ankle-foot orthosis on muscle activity during walking: A randomized study of patients with unilateral foot drop☆1,☆2,☆3,☆4,☆5,☆6,☆7,☆8,☆9
Section snippets
Subjects
Fourteen healthy volunteers (8 women, 6 men; mean age ± standard deviation [SD], 33.2 ± 10.2y) recruited from staff and students at our research institute and 29 patients (21 men, 8 women) with a recent unilateral peripheral paresis of the ankle dorsiflexors participated in all studies. Patients were recruited from regional hospitals. Because no exact SDs were available, sample size was not based on power analysis but on practical considerations (ie, availability of patients). Each subject met
Reproducibility
The differences in mean electromyographic production between the first and second measurement sessions were calculated for each muscle with and without AFO use. Electromyographic activity between T0 and T2 was not significantly different (table 3).Empty Cell TA (%) EDL (%) SOL (%) GAS (%) PL (%) Without AFO 0 (±13) −9 (±23) 2 (±14) −17 (±53) −6 (±23) With AFO 2 (±27) −13 (±31) −0 (±16) 4 (±39)
Discussion
In clinical practice, the question often arises whether an orthosis diminishes muscle activity, thereby worsening an existing paresis. In a case of foot drop, an AFO is often prescribed to restore a more normal and safe walking pattern. In this study, we evaluated the effect of AFO use on electromyographic activity of 5 lower leg muscles in healthy and recent paretic subjects. We found a significant decrease of 7% and 20%, respectively, in paretic and healthy subjects in tibialis anterior
Conclusion
Although AFO use significantly reduces electromyographic activity of the tibialis anterior in healthy subjects (20% during the first 15% of the step cycle), and in paretic subjects (7% calculated over the step cycle as a whole), the reduction does not accumulate over time. This decrease in electromyographic activity during AFO use is easily compensated for by an increase in total walking activity facilitated by AFO use. Therefore, even in recent paretic subjects, no contraindication exists for
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The influence of early or delayed provision of ankle-foot orthoses on pelvis, hip and knee kinematics in patients with sub-acute stroke: A randomized controlled trial
2018, Gait and PostureCitation Excerpt :On the other hand, papers reported that clinicians might fear (early) AFO-use, as this could lead to muscle-disuse. Consequently, delays in recovery and permanent gait impairments are feared [6,10,11]. Clear evidence of the long-term effects of timing of AFO-provision on gait kinematics after stroke is missing.
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Supported by the Rehabilitation Foundation Limburg, Hoensbroek, and the Foundation De Drie Lichten, the Netherlands.
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
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Reprint requests to Johanna F. Geboers, MD, iRv, Institute for Rehabilitation Research, PO Box 192, 6430 AD Hoensbroek, the Netherlands, e-mail: [email protected].
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Suppliers
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a. K-Lab Kinesiology, Lorentzkade 34 2014 CA Haarlem, Amsterdam.
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b. Medi-Trace®; The Ludlow Co LP, a Tyco Healthcare Co, 2 Ludlow Park Dr, Chicopee, MA 01022.
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c. Otto-Bock Orthopedic Industry GmbH & Co, Max Näderstr 15, 37115 Duderstadt, Germany.
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d. The Math Works Inc, 24 Prime Park Way, Natick, MA 01760.
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e. SPPS Inc, 233 S Wacker Dr, 11th Fl, Chicago, IL 60606.