Stair ascent and descent biomechanical adaptations while using a custom ankle–foot orthosis

Abstract The ability to navigate stairs step-over-step is an important functional outcome following severe lower leg injury and is difficult for many patients. Ankle–foot orthoses, such as the Intrepid Dynamic Exoskeletal Orthosis (IDEO), are often prescribed to improve function. This study compared...

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Bibliographic Details
Published in:Journal of biomechanics 2016-09, Vol.49 (13), p.2899-2908
Main Authors: Aldridge Whitehead, Jennifer M, Russell Esposito, Elizabeth, Wilken, Jason M
Format: Article
Language:English
Subjects:
Adaptation, Physiological
Adult
Ankle
Ankle Joint - physiopathology
Biomechanical Phenomena
Biomechanics
Foot Orthoses
Gait
Grounds
Humans
IDEO
Injuries
Kinematics
Kinetics
Knee - physiopathology
Knee Joint
Knees
Leg Injuries - physiopathology
Leg Injuries - therapy
Limb preservation
Limb salvage
Limbs
Male
Military
Orthoses
Physical Medicine and Rehabilitation
Range of Motion, Articular
Stair Climbing
Stairways
Standard deviation
Wrist
Young Adult
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Summary:Abstract The ability to navigate stairs step-over-step is an important functional outcome following severe lower leg injury and is difficult for many patients. Ankle–foot orthoses, such as the Intrepid Dynamic Exoskeletal Orthosis (IDEO), are often prescribed to improve function. This study compared stair climbing mechanics between IDEO users and able-bodied control participants. Thirteen IDEO users who sustained severe lower leg injury and 13 controls underwent biomechanical gait analysis. Participants ascended and descended a 16-step instrumented staircase without handrail use at a controlled cadence of 80 steps/min. Peak joint angles, moments, powers, and ground reaction forces, and integrated mechanical work were calculated. Independent t -tests with Bonferroni-Holm corrections were used to compare controls to IDEO and sound limbs. Reduced ankle range of motion on the IDEO limb resulted in compensatory strategies while ascending or descending stairs. During ascent, IDEO users had greater bilateral hip power during pull-up ( p
ISSN:0021-9290
1873-2380
DOI:10.1016/j.jbiomech.2016.06.035