KINETIC AND KINEMATIC GAIT ASSESSMENT OF PARAPLEGIC PATIENTS WITH AND WITHOUT ANKLE FOOT ORTHOSES

Karina Cristina Alonso, Enio Walker Azevedo Cacho, Eliza Regina Ferreira Braga Machado de Azevedo, Fernando Tardeu Bueno Martin, Alberto Cliquet Junior

Abstract

Objective: To assess the influence of rigid ankle foot orthoses (AFOs) on paraplegic gait with neuromuscular electrical stimulation (NMES). Methods: Ten control subjects and five complete paraplegics went through kinetics and kinematics gait evaluation without and with AFOs. Paraplegics also used 4 channels NMES, walker aided. Results: Cadence, in steps per minutes (94.6/6.8; 84.97/13.15; 13.02/4.11; 16.1/2.29), step length, in meters (1.31/0.15; 1.19/0.17; 0.55/0.11; 0.6/0.11) and % stance time (61.5/1.8; 62.93/3.37; 87.8/7.26; 89.9/2.6) for controls and paraplegics, without and with AFOs, respectively. Differences are shown for the controls as well as between paraplegic groups. Ankle joints kinematics displayed no significant changes. However, the ankle dorsiflexion, in the support phase, for controls and paraplegics with AFO was higher than expected (10.97/5.67; 15.48/8.08). Kinetic values were: maximum hip extensor moments (Nm/kg) of 1.84/0.48; 3.36/5.79; 1.45/0.59; 1.58/0.41 and maximum knee extensor moments of 3.53/0.52; 3.04/0.87; 1.44/1.37; 1.24/0.78. Conclusion: Within the paraplegic groups, through spatiotemporal results, gait with AFO was more effective. Nevertheless, the AFO allowed more ankle mobility than expected. Furthermore, lower limb loading, i.e. hip and knee moments generated during NMES+AFO paraplegic gait allows for bone mass increase.

References

  1. Abel, M.F., Juhl, G.A., Vaughan, C.L., Damiano, D.L., 1998. Gait assessment of fixed ankle-foot orthoses in children with spastic diplegia. Arch Phys Med Rehabil. v. 79, p. 126-133.
  2. Barbeu, H., Ladouceur, M., Norman, K.E., Pépin, A., 1999. Walking after spinal cord injury: evaluation, treatment, and functional recovery. Arch Phys Med Rehabil. v. 80, p.225-235.
  3. Behrman, A.L., Harkema, S.J., 2000. Locomotor training after human spinal cord injury: a series of case studies. Physical Therapy. n. 7, v. 80, p. 688-699.
  4. Carvalho, D.C., Cliquet, A. Jr., 2005. Response of the arterial blood pressure of quadriplegic patients to treadmill gait. Braz J Med Biol Res. n. 38, v. 9, p. 1367-1373.
  5. Carvalho, D.C., Garlipp, G.R., Bottini, P.V., Afaz, S.H., Moda, M.A., Cliquet, A.Jr., 2006. Effect of treadmill gait on bone markers and bone mineral density of quadriplegic subjects. Braz J Med Biol Res. n. 39, v.10, p. 1357-1363.
  6. Kim, M., Eng, J.J., Whittaker, M.W., 2004. Effects of a simple functional electric system and/or a hinged ankle-foot orthosis on walking in persons with incomplete spinal cord injury. Arch Phys Med Rehabil. v. 85, p. 1718-1723.
  7. Radtka, S.A., Oliveira, G.B., Lindstrom, K.E., Borders, M.D., 2006. The kinematic and kinetic effects of solid, hinged, and no ankle-foot orthoses on stair locomotion in healthy adults. Gait and Posture. n. 24, p. 211-218.
  8. Sawicki, G.S., Domingo, A., Ferris, D.P., 2006. The effects of powered ankle-foot orthoses on joint kinematics and muscle activation during walking with incomplete spinal cord injury. Journal of NeuroEngineering and Rehabilitation. n.3, v.3, p.1-17.
  9. Sepulveda, F., Granat, M.H., Cliquet, A. Jr., 1997. Two artificial neural systems for generation of gait swing by means of neuromuscular electrical stimulation. Med Eng Phys. n. 1, v. 19, p. 21-28.
Download


Paper Citation


in Harvard Style

Alonso K., Cacho E., de Azevedo E., Martin F. and Cliquet Junior A. (2010). KINETIC AND KINEMATIC GAIT ASSESSMENT OF PARAPLEGIC PATIENTS WITH AND WITHOUT ANKLE FOOT ORTHOSES . In Proceedings of the Third International Conference on Biomedical Electronics and Devices - Volume 1: BIODEVICES, (BIOSTEC 2010) ISBN 978-989-674-017-7, pages 98-102. DOI: 10.5220/0002718700980102


in Bibtex Style

@conference{biodevices10,
author={Karina Cristina Alonso and Enio Walker Azevedo Cacho and Eliza Regina Ferreira Braga Machado de Azevedo and Fernando Tardeu Bueno Martin and Alberto Cliquet Junior},
title={KINETIC AND KINEMATIC GAIT ASSESSMENT OF PARAPLEGIC PATIENTS WITH AND WITHOUT ANKLE FOOT ORTHOSES},
booktitle={Proceedings of the Third International Conference on Biomedical Electronics and Devices - Volume 1: BIODEVICES, (BIOSTEC 2010)},
year={2010},
pages={98-102},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0002718700980102},
isbn={978-989-674-017-7},
}


in EndNote Style

TY - CONF
JO - Proceedings of the Third International Conference on Biomedical Electronics and Devices - Volume 1: BIODEVICES, (BIOSTEC 2010)
TI - KINETIC AND KINEMATIC GAIT ASSESSMENT OF PARAPLEGIC PATIENTS WITH AND WITHOUT ANKLE FOOT ORTHOSES
SN - 978-989-674-017-7
AU - Alonso K.
AU - Cacho E.
AU - de Azevedo E.
AU - Martin F.
AU - Cliquet Junior A.
PY - 2010
SP - 98
EP - 102
DO - 10.5220/0002718700980102