Recherche clinique sur le pied et la cheville

Abstrait

Comparing Plantarflexor Power and Function using Carbon Fiber Versus Traditional Thermoplastic Ankle Foot Orthoses: Case Series

Mary K Hastings, Michael M Dailey, Dequan Zou, David R Sinacore and Michael Mueller

Background: Thermoplastic ankle foot orthoses (TAFO) control the foot during swing and initial contact of walking. Carbon fiber AFOs (CAFO) has the added ability to store and return energy at push off. The purpose of this report is to determine if plantarflexor power and function can be improved with a CAFO compared to a TAFO and identify factors that may be related to plantarflexor power improvement in two adults with reduced ankle muscle performance.
Case Descriptions: Two participants with reduced ankle muscle performance completed a gait analysis and the 6 minute walk (6MW) test wearing each AFO. Physical function was higher in Participant 1 compared to Participant 2 as measured by the Foot and Ankle Ability Measure and walking speed.
Outcomes: Participant 1’s 6MW distance and plantarflexor power improved wearing the CAFO compared to the TAFO (6MW distance: TAFO=427 m, CAFO=553 m and Plantarflexor power: TAFO=1.16 W/kg, CAFO=1.56 W/kg). Participant 2 showed similar outcomes in both AFO conditions (6MW distance: TAFO=290 m, CAFO=276 m and plantarflexor power: TAFO=0.89 W/kg, CAFO=0.60 W/kg).
Discussion: A CAFO increased walking speed and plantarflexor power compared to a TAFO in a person with a relatively high level of physical function but not in a person with a relatively low level of physical function. These preliminary results suggest a sufficiently high level of physical function is required to “engage” the CAFO and benefit from its energy storing capabilities.