Ankle strategy assistance to improve gait stability using controllers based on in-shoe center of pressure in 2 degree-of-freedom powered ankle-foot orthoses: a clinical study.
Ho Seon Choi, Yoon Su Baek, Hyunki In
PMID 36284358WHAT IT FOUND
Walking became more stable on a measure at the highest assistance, but body sway increased and another stability measure did not change in seven healthy adults using a powered ankle-foot orthosis.
Key findings
01Postural sway was higher than unpowered in PCDC-A, PCDC-B, and PCDC-C, with ratios 1.099, 1.105, and 1.092 (p < 0.008).
02Wearers were more stable during PCDC-C than during unpowered, with an LLE ratio of 0.948 (p < 0.008).
03EMG activity decreased by 5.6, 12.6, and 16.1% in PCDC-A, PCDC-B, and PCDC-C compared with unpowered, and all reductions were significant (p < 0.008).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only seven healthy adults with no history of gait abnormalities, so it does not show effects in patients. There was no condition without the orthosis, so the effect of wearing it versus not wearing it was not tested. The study did not measure gait stability with a 1 degree-of-freedom orthosis in the same experiment, although previous work suggested differences. Foot slippage was not measured, and the authors note it could affect foot pressure location. The controllers were pre-defined and not proven optimal. The small sample and multiple comparisons led to a stricter significance threshold of p < 0.008. Participants were already familiar with the device from previous experiments.
Declared interests
No funding or conflict-of-interest declaration appears in the supplied article text. The supplied publication types list research support from a non-U.S. government.
The easy way to misread this
Do not conclude that this orthosis improves gait stability for patients or reduces fall risk. The study included seven healthy adults, postural sway increased with assistance, a stability measure did not change, and a stability measure improved at the highest assistance.