Active Foot Orthosis

Variability was positively related to the number of falls. Patients with knee OA also demonstrate that reducing the variability of walking18. Reducing variability of sagittal knee kinematics appears to reduce fall risk. The moment at the ankle joint were reduced in the patient with knee OA, this is was associated with the reduction of powers generated by the ankle plantar flexors in pre-swing15. This may indicate that reducing push off in pre-swing was a conscious effort to facilitate knee OA patients walking at lower gait speed, in order for more dynamic

There are thousands of individuals from pediatrics to geriatrics that suffer from lower body injuries, chronic pain, neurological conditions, and amputations that will inhibit their mobility. However, with technology ever evolving it has brought forth a machine known as an anti-gravity treadmill. This machine can change the lives of many individuals and become a game changer in the Occupational Therapy profession. Having more of these machines in Occupational Therapy clinics will be more beneficial for clients and help to give them a better quality of life.

The purpose of the barefoot running study article is to determine whether runners can achieve the propose of favorable kinematic changes and reduction in loading rate after a progressive training program. The article designed a study that hypothesized that not all individuals would experience a decrease in initial loading rate facilitated by increased ankle plantar flexion after a progressive barefoot running program but would further a relationship that exist between changes in initial loading and sagittal ankle

In this essay the author will take a brief look at the structure of the foot and then describe the muscles involved in dorsiflexion of the foot and the changes that occur in the lower limb.

He completed 20 months of extensive rehabilitation following his injury and was performing as a highly functional independent in his community. Six months after completing his rehabilitation program, the patient volunteered for the VR-based gait training program, continuing his normal activity profile outside the training and did not start a new exercise program or make any changes to his prosthetic limb. The VR-system involved projected a VR-environment and visual feedback on the inside of a dome. A 24-camera motion capture system within the dome was used to track 3-dimensional, full-body mechanics. The training environment consisted of a straight walking path through a forested area designed to minimize distractions from the visual feedback displayed on the screen in front of the patient. The feedback was a display of a real-time, full-body virtual representation of the person and a trace of the frontal-plane trunk motion (marker at C7). To help assist the treating therapist in noticing deviations in pelvis motion, graphs of the frontal, transverse, and sagittal-plane pelvic motion were projected directly behind the

There were few significant differences in knee extensor and knee flexor muscle activity during walking with robotic assistance. Significant differences in muscle activity across condition only occurred in muscles targeted for intervention (knee extensor, VL), with an increase in muscle activity during the EXO condition, a positive result for an extensor muscle. Although some undesirable increases in MH flexor muscle activity were seen in the linear envelopes, they did not present significant changes the statistical analysis on the group level. Muscle activity did not change significantly across visits with the exoskeleton.

If you are struggling to do daily activities because of foot pain, you are not alone. Many people encounter foot pain while walking, exercising or even standing. Costly surgery and treatments are not the only option to relieve this pain. Custom orthotics have been used by thousands of people to relieve their pain and bring a spring back into their step.

There were several different interventions performed aimed at increasing range of motion, balance/proprioception, and to increase strength of the right lower extremity. Following the initial examination and evaluation a brief therapeutic exercise period ensued. The gastrocnemius and soleus were both stretched against a wall each for two sets of 60 seconds to help increase dorsiflexion range of motion (Radford, Burns, Buchbinder, Landford, Cook, 2006). Active range of motion for dorsiflexion, plantarflexion, inversion and eversion was performed on a wobble board while seated for 20 repetitions in each directions to increase range of motion, but more importantly to improve proprioception (Bernier and Perrin, 1998). Plantar flexion strength was addressed by utilizing green thera-tubing around the forefoot with the patient holding the other end of the tube. This was performed for one set of 20 repetitions. Body weight squats using a railing for support were chosen as they are a closed kinetic chain exercise that challenges the gluteus muscle group as well as hamstrings while also causing dorsiflexion of the ankles (Gryzlo SM, Patek RM, Pink M, Perry J, 1994). Closed chain exercises were started initiated at the first visit as they cause an increase in joint compressive forces which can lead to increased stability, increased muscle activation, and decreased joint shearing forces (Harter, 1996). Supine bridges on a 55 cm theraball were performed for 20 repetitions to address the

The article “Muscular contributions to hip and knee extension during the single limb stance phase of normal gait: a Theoretical Framework for Crouch Gait” by Allison Arnold, Frank Anderson, Marcus Pandy, and Scott Delp investigates the biomechanics of normal gait in hopes to uncover ideas to help determine treatments for crouch gait. Crouch gait is a bothersome abnormality that affects the gait pattern of people who suffer from the condition of cerebral palsy. It’s characterized by excessive flexion of the hips and knees during standing and excessive use of metabolic energy to complete a single gait cycle. Currently, the treatments for this condition are limited and have unpredictable outcomes due to the unknown biomechanical causes of the excessive flexion in crouch gait. These treatments include surgical lengthening of hamstrings, ankle-foot orthoses, and intense stretching regimens, with patients experiencing results ranging from no improvement in their symptoms to dramatic improvements. The vast array of results from treatments are due to the little understanding medical professionals have of not only abnormal gait patterns (such as crouch gait) but of normal gait as well (Arnold, Anderson, Pandy, and Delp, 2005). Despite the article’s title relating to crouch gait, the purpose of the study conducted was to examine and quantify the accelerations of normal hip and knee movements that were induced by specific muscles during the single limb stance phase and to rank these

Capasso et al (1989) made a comparison of adhesive and non-adhesive tape when applied to the ankle. The authors determined that non-adhesive tape must be exchanged every three days due to loss of compression, and also confirmed that adhesive tape could be left on for five days. In this study, the forces were measured by merging a sphygmomanometer with the ankle taping. However, such method did not reveal an exact measurement and thus it was criticized. The subjects were instructed to heel strike, foot weight bear and toe-off weight bear while the data was collected in between phases as they held the position. This mechanical function did not reflect a real time gait cycle and therefore it was an inaccurate representation to gait. Furthermore,

Ankle and foot orthotics or AFO are custom made inserts that are shaped to fit inside a shoe to provide cushioning or to correct irregular walking gait. It is a brace that surrounds the ankle and is made from metal, leather, synthetic fabrics, plastic, or any combination. Orthotics came in a variety of models and sizes including the customized and the over the counter variants. Customized orthotics should be prescribed by a podiatrist who specializes in customized footwear and orthotic design.

This was an interesting article. It examined the use of electrical stimulation as a treatment for spasticity in the ankle plantar muscles, specifically the tibias posterior, gastrocnemius, and soleus. Electrodes were placed over the extensor digitorum longus muscles and the extensor hallicus muscles of post stroke patients with plantar flexor spasticity. Various intensities were tested. The article explains that spasticity in the ankle plantar flexors can lead to an equinovarus or strephenopodia deformity. The article also recognizes the common use of botulinum injections which

It is recommended within the general population to reduce the risk of osteoarthritis that individuals maintain a healthy weight within recommended limits, and continually participate in regular physical activity, especially resistance and strength training (Zhang et al., 2010). For amputees in particular, current research is looking into the potential benefits of bio-powered ankle and knee joints with the hope of reducing the higher load rates seen in the joints of the sound limb. Bio-powered ankle joints help to replicate the active push-off at the ankle joint that is not present in energy storing or conventional SACH foot prostheses. Increasing the push-off of the trailing limb has been shown to reduce the load on the leading limb during walking (Donelan et al., 2002, Adamcyz et al., 2009; Kuo et al., 2007). In addition to the load placed on the leading limb during walking, the 1st peak EKAM was reduced when there was an increased push-off work from the trailing limb prosthetic ankle. In Daved et al’s study, the CESR bio-powered ankle prosthesis had the largest magnitude of push-off and reduced the 1st peak intact EKAM by 26% compared to the conventional ankle foot prosthesis (Daved et al., 2011). This study also noted a trend between the leading limb impulse and the 1st peak intact EKAM, with

For the three-direction SEBT, requirements include a level floor, some adhesive athletic tape positioned at one hundred and twenty degree angles to each other in the ANT, PM and PL directions, a measuring tape, a pencil and eraser (Gribble et al., 2013; Coughlin et al., 2012). Footwear will not be completely standardized for this study, as participants will be asked to wear whatever footwear they normally use during physical exercise as the majority of ankle injuries will occur during physical activity, during which athletic shoes are most often worn. Average peroneus longus activity, an ankle evertor responsible for maintaining ankle stability (Neptune et al., 1999), does not differ between a standard shoe and when a custom

Certain functional abilities such as walking need some amount of dorsiflexion, minimum of 10 degrees of dorsiflexion (mecagni et al). With the ageing ankle dorsiflexion range of motion is reduced Chesworth et al, 1992). Decreased ankle range of motion alters movement patterns declining the balance of these patients (Elin et al, 2011) (Mecagni et al). Furthermore, decreases in postural control may result from the use of motions at the hip or trunk that are required to compensate for restrictions in motion at the ankle (Mecagni et al).