Biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosis.
Ross M Neuman, Staci M Shearin, Karen J McCain and 1 others
PMID 34176484WHAT IT FOUND
Five people with MS who wore a simple, passive hip orthosis showed significant increases in peak hip flexion angle and net hip work.
The device was well-tolerated, but muscle activity responses were highly variable, suggesting individualized fitting is required.
Key findings
01All participants with MS experienced a significant increase in peak hip flexion angle in the assisted leg when wearing the orthosis.
02Net work produced by the assisted hip increased during orthosis trials for all subjects with MS.
03Muscle activity responses were inconsistent across participants, with some showing increased hip extensor activity and others showing decreases.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Very small sample size (5 MS, 5 controls) limits generalizability. Single testing session prevents assessment of long-term adaptation or motor learning. Treadmill walking may not fully replicate overground gait characteristics. Participants could not acclimate to the device or make individualized adjustments during testing, which may have influenced results. Surface EMG could not measure the iliopsoas, the primary hip flexor. High variability in muscle activity responses makes it difficult to establish a consistent neuromuscular mechanism.
Declared interests
The authors declare no competing interests. The study was supported by non-U.S. government funding.
The easy way to misread this
Do not interpret the improved hip kinematics as evidence that this device will improve functional walking speed or reduce fall risk in clinical practice. The study measured biomechanical variables in a controlled, single-session treadmill setting, not functional outcomes or long-term usage. The highly variable muscle activity responses indicate that the device does not produce a uniform neuromuscular effect, so individual fitting and assessment are critical before assuming benefit.