Effects of ankle joint degree of freedom of knee-ankle-foot orthoses on loading patterns and triceps surae muscle activity on the paretic side in individuals with subacute severe hemiplegia: a retrospective study.
Ayumu Ogura, Yuta Chujo, Naoto Mano and 5 others
PMID 39227980WHAT IT FOUND
Letting a KAFO ankle bend up to 20 degrees increased front-to-back movement of foot pressure and outer calf activity in the second half of stance.
Most foot loading and soleus measures did not change.
Key findings
01The front-to-back movement of the foot pressure path was larger under the free ankle condition.
02Outer calf activity in the second half of stance was higher under the free ankle condition, while soleus activity did not differ.
03People with lower leg motor and trunk scores had more front-to-back pressure movement and medial forefoot loading when the ankle was fixed.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This was a retrospective analysis of data collected for routine care, so it cannot establish cause and effect and may have unmeasured confounders. Only 14 people were included, and 5 of them had only one measurement, so the results may not apply widely. The amount of physical assistance was not consistent across trials, even though only two therapists measured gait. Hip motion and other kinematic factors that could affect pressure and muscle activity were not measured. Effects of higher brain dysfunction, such as neglect, were not considered. All participants required a knee-ankle-foot orthosis for severe knee instability and scored 0 on the Functional Ambulation Category, so this does not speak to milder walkers. The study measured foot pressure and muscle activity during assisted gait, not walking independence.
Declared interests
Funded by the Japan Society for the Promotion of Science. No author conflicts of interest are reported.
The easy way to misread this
Do not conclude that a free-ankle KAFO alone improves walking. The ankle setting was tested during therapist-assisted gait with a thigh belt and alternate hip exercises, and the study did not measure walking independence.