The effects of powered ankle-foot orthoses on joint kinematics and muscle activation during walking in individuals with incomplete spinal cord injury

Journal of NeuroEngineering and Rehabilitation, 2006 · DOI: 10.1186/1743-0003-3-3 · Published: February 28, 2006

Spinal Cord Injury Assistive Technology Biomechanics

Simple Explanation

This study investigates how powered ankle-foot orthoses affect walking in people with incomplete spinal cord injuries. The goal was to see if the robotic assistance could improve their walking patterns without reducing their own muscle activity. The study involved participants walking on a treadmill with and without the powered orthoses, both unpowered and powered by a therapist. The results showed that the powered orthoses improved ankle movement during push-off without significantly decreasing muscle activation. The findings suggest that this type of robotic assistance could be a useful tool in gait rehabilitation, helping patients improve their walking ability without becoming overly reliant on the device.

Study Duration

Not specified

Participants

5 individuals with chronic incomplete spinal cord injury (ASIA C-D)

Evidence Level

Not specified

Key Findings

1
Powered ankle-foot orthoses increased ankle angle at stance push-off compared to passive orthoses.
2
Soleus muscle activation was slightly lower (~13%) with powered orthoses compared to passive orthoses.
3
Maximum ankle angle at push-off was smaller when subjects controlled the orthoses compared to therapist control.

Research Summary

This study examined the effects of powered ankle-foot orthoses on the walking patterns of individuals with incomplete spinal cord injury. The orthoses provided plantar flexion assistance, and the study measured joint angles, muscle activation, and orthosis torque. The results indicated that the powered orthoses improved ankle push-off kinematics without substantially reducing muscle activation. This suggests that robotic plantar flexion assistance could be used in gait rehabilitation without promoting patient passivity. The study also found that therapist-controlled assistance was more effective than patient-controlled assistance, suggesting a need for simplified control interfaces in self-operated robotic rehabilitation devices.

Practical Implications

Rehabilitation Tool

Powered ankle-foot orthoses can be used as a rehabilitation tool to improve ankle push-off kinematics in individuals with incomplete spinal cord injury.

Reduced Therapist Labor

Powered orthoses could reduce the physical burden on therapists during gait rehabilitation by automating assistance.

Control Interface Improvement

Self-operated robotic rehabilitation devices need higher-level controllers that simplify the control interface and reduce patient cognitive effort.

Study Limitations

1
Small sample size (five subjects) limits the generalizability of the findings.
2
Only two subjects were able to effectively control the orthoses themselves.
3
The study was conducted within a single test session following a single training session, limiting insight into long-term training effects.

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