短下肢装具の可撓性が歩行に及ぼす影響

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  • THE EFFECTS OF THE FLEXIBILITY OF ANKLE-FOOT ORTHOSES ON GAIT

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The effects of the flexibility of ankle-foot-orthoses (AFO) on hemiplegic gaits were examined by kinetic model analysis. A kinetic model of the gait with AFO has been developed in the sagittal plane. We found that in order to calculate muscle moment at the ankle joint, we must know the correcting moment of the AFO. A measuring AFO was developed, and we estimated the correcting moment of the measuring AFO using static balance characteristics and measuring the way the AFO was deformed in walking. Altering the flexibility of the measuring AFO, the timing of gait events and step length, the joint angular displacements, and joint moments were measured. Using the kinetic gait model, the joint moment at the ankle joint was divided into two factors, the joint moment caused by muscle forces and the moments of correction by the AFO. The results are as follows: (1) During the entire gait cycle, tight AFO generated larger correcting moment than flexibile AFO. But the amplitudes of the correcting moment were less than 10% of the ankle joint moment caused by muscle forces. (2) The ankle joint moment was altered dramatically by wearing an AFO. The maximum amplitude of plantarflexion moment was increased by wearing the AFO, and the increment exceeded the AFO correcting moment. (3) The knee joint moments were altered by wearing the AFO. From these results, we presumed that the AFO alters joint moment, not only by its own correcting moment but also by modifying the way its user walks.

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