Original articleThe Effect of Custom-Made Braces for the Ankle and Hindfoot on Ankle and Foot Kinematics and Ground Reaction Forces
Section snippets
Methods
Twenty normative subjects (10 men, 10 women) were evaluated. Mean age was 46 years (range, 27−65y) and body mass index averaged 25kg/m2 (range, 20−34kg/m2). Subjects who had previous ankle or foot pathologies, systemic rheumatic diseases, lower-extremity arthritis, joint replacement, or other disorders affecting gait were excluded.
Braces for the study were custom-made for each subject by practitioners certified in orthotic and prosthetic design. Each subject received and was tested while
Kinematics
In the sagittal plane (table 1), both the AFO and the HFO-R reduced maximal hindfoot plantarflexion and total hindfoot sagittal motion, compared with the unbraced shod and HFO-A conditions (P<.05) (fig 5). The AFO was associated with less hindfoot dorsiflexion than the HFO-A (P<.05). There were no differences between the HFO-A and the unbraced shod conditions, or between the AFO and the HFO-R conditions with respect to hindfoot maximal plantarflexion, maximal dorsiflexion, and total sagittal
Discussion
Few gait studies have focused on the effect of foot and ankle orthoses with respect to kinematic and kinetic measures. This study is important because it demonstrates that with recently developed foot-specific gait analysis techniques, it is possible to critically assess foot and ankle function while subjects are walking. To our knowledge, orthosis testing using foot specific methods, as opposed to whole body gait analysis, has not been previously reported. Our study complements information
Conclusions
The AFO and the HFO-R limited sagittal talocrural motion to a greater degree than did the HFO-A, which was forced to limit the midfoot motion. All braces limited coronal motion, with the AFO being the most restrictive of the 3. The HFO-A and the AFO limited transverse motion. However, braces that limited ROM most effectively were also associated with more atypical kinetic patterns, thereby signifying a more tentative, less dynamic gait. The HFO-A was most similar to the unbraced shod condition
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