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Related Experiment Videos

Plastic ankle-foot orthoses: evaluation of function.

J F Lehmann, P C Esselman, M J Ko

    Archives of Physical Medicine and Rehabilitation
    |September 1, 1983
    PubMed
    Summary

    Plastic ankle-foot orthoses (PAFOs) effectively manage gait issues in hemiplegia. The Seattle design PAFO offers superior resistance for severe spasticity, while modified versions suit milder cases.

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    Area of Science:

    • Biomechanics
    • Rehabilitation Engineering
    • Orthotics

    Background:

    • Plastic ankle-foot orthoses (PAFOs) are crucial for individuals with hemiplegia to address gait deviations like foot drop and inadequate push-off.
    • Effective PAFO function requires sufficient plantarflexion resistance for toe clearance during swing and dorsiflexion resistance to support late stance.
    • Optimizing PAFO design is essential for improving gait mechanics and functional mobility in hemiplegic patients.

    Purpose of the Study:

    • To evaluate the plantarflexion and dorsiflexion resistance of five different Plastic ankle-foot orthoses (PAFOs).
    • To compare the functional performance of various PAFOs in both hemiplegic and able-bodied individuals during gait.
    • To determine the suitability of different PAFO designs for varying degrees of plantarflexor spasticity.

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    Main Methods:

    • Five distinct Plastic ankle-foot orthoses (PAFOs) were assessed for their resistance properties.
    • A self-aligning goniometer was used to measure ankle angles during walking.
    • A gait event marker system recorded key gait events to analyze performance.

    Main Results:

    • The Seattle design polypropylene orthosis demonstrated the least flexibility and highest resistance, proving effective for severe plantarflexion spasticity and providing robust gastrocnemius-soleus substitution.
    • Progressive modifications to the Seattle design orthosis increased its flexibility, making its performance comparable to the Engen and Teufel orthoses.
    • While the Engen and Teufel orthoses offered adequate toe clearance, they provided less effective push-off substitution compared to the malleoli-enclosing Seattle design.

    Conclusions:

    • The Seattle design Plastic ankle-foot orthosis (PAFO) is highly effective for managing severe plantarflexion spasticity and providing essential gait support.
    • Modified or more flexible PAFOs, such as the trimmed Seattle design, Engen, and Teufel orthoses, are suitable for individuals with mild to moderate plantarflexor spasticity.
    • PAFO selection should be tailored to the individual's specific gait abnormalities and spasticity levels for optimal outcomes.