Experimental comparisons of passive and powered ankle-foot orthoses in individuals with limb reconstruction.
Elizabeth Russell Esposito, Kelly A Schmidtbauer, Jason M Wilken
PMID 30463576WHAT IT FOUND
In three service members with limb reconstruction, a powered ankle-foot orthosis did not consistently lower walking metabolic cost.
It increased push-off power and ankle motion, but all preferred their daily orthoses.
Key findings
01No single device consistently provided the lowest net metabolic cost across speeds.
02The powered orthosis increased peak push-off power in the affected limb relative to all other tested conditions.
03Subjects preferred the orthoses they wore daily, and the added mass was the primary criticism of the powered orthosis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only three subjects were tested, and no full statistical analysis was performed, so the findings are descriptive. The powered device was a prototype tested only in the laboratory, with relatively short accommodation time. The powered orthosis was much heavier than the passive devices, at 3.4 kg compared with 0.3 kg and 1.9 kg. Some testing was interrupted by power losses, and P01 could not complete the Blue Rocker T-test due to pain. Participants had high performance expectations and prior experience with high-performance carbon fiber bracing, so their comments reflected limitations for high-energy activities to which they were accustomed. The population was heterogeneous, with different impairments and ankle power deficits.
Declared interests
Funding was provided by the Telemedicine and Advanced Technology Research Center. The supplied text gives no author conflict-of-interest declaration.
The easy way to misread this
Do not conclude that the powered ankle-foot orthosis should replace current orthoses. It did not consistently lower walking metabolic cost, and agility results were mixed, although it increased push-off power and ankle motion in three service members. This was a laboratory case series without full statistical analysis, and all participants preferred their daily orthoses.