TY - JOUR
T1 - Gait of stance control orthosis users
T2 - The Dynamic Knee Brace System
AU - Irby, Steven E.
AU - Bernhardt, Kathie A.
AU - Kaufman, Kenton R.
N1 - Funding Information:
The authors wish to gratefully acknowledge the support of Robert Lotz of Prosthetic Orthotic Center, and Richard Miller of Prosthetic Laboratories of Rochester for their support in KAFO fabrication and patient recruitment. They also wish to acknowledge the staff of the Motion Analysis Laboratory, and in particular Diana Hansen, for motion data collection and reduction. This project has benefited from the efforts of a great many contributors. To list the known contributors over the last 20 years of conversations and smaller projects is not feasible. However, the contributions of three individuals rise to the top: (1) Dr David H. Sutherland recognized the need, provided the conviction necessary to initiate this work, and recruited the help of the following two gentlemen; (2) Eugene Meade, who provided the inspiration to use a wrap spring clutch in this application, and (3) Larry L. Malcolm supervised the design and construction of the first working wrap spring clutch stance phase control orthosis. This project was supported by the Mayo Foundation, and the National Institutes of Child Health and Human Development grant HD30150.
PY - 2005/12
Y1 - 2005/12
N2 - Individuals with weak or absent quadriceps who wish to walk independently are prescribed knee-ankle-foot orthoses (KAFOs). New stance control orthosis (SCO) designs automatically release the knee to allow swing phase flexion and extension while still locking the joint during stance. Twenty-one participants were fitted unilaterally with the Dynamic Knee Brace System (DKBS), a non-commercial SCO. Thirteen subjects were experienced KAFO users (average 28 ± 18 years of experience) while eight were novice users. Novice users demonstrated increased velocity (55 vs. 71cm/sec, p = 0.048) and cadence (77 vs. 85 steps/min, p < 0.05) when using the DKBS over the traditional locked KAFO. Experienced KAFO users tended to have reduced velocity and cadence measures when using the SCO (p < 0.10). Knee range of motion was significantly greater for the novice group than for the experienced group (55.2 ± 4.8 vs. 42.6 ± 3.8°, p = 0.05). Peak knee extension moments tended to be greater for the experienced group (0.29 ± 0.21 vs. 0.087 ± 0.047 Nm/kg, p = 0.09). This report describes gait changes during the introductory phase of DKBS adoption. Experienced KAFO users undoubtedly had ingrained gait patterns designed to compensate for walking with a standard locked KAFO. These patterns may have limited the ability of those users from taking full and immediate advantage of the SCO capabilities. Also, alternate SCO systems may engender different results. Comparison studies and longer term field studies are needed to clarify benefits of the various bracing options.
AB - Individuals with weak or absent quadriceps who wish to walk independently are prescribed knee-ankle-foot orthoses (KAFOs). New stance control orthosis (SCO) designs automatically release the knee to allow swing phase flexion and extension while still locking the joint during stance. Twenty-one participants were fitted unilaterally with the Dynamic Knee Brace System (DKBS), a non-commercial SCO. Thirteen subjects were experienced KAFO users (average 28 ± 18 years of experience) while eight were novice users. Novice users demonstrated increased velocity (55 vs. 71cm/sec, p = 0.048) and cadence (77 vs. 85 steps/min, p < 0.05) when using the DKBS over the traditional locked KAFO. Experienced KAFO users tended to have reduced velocity and cadence measures when using the SCO (p < 0.10). Knee range of motion was significantly greater for the novice group than for the experienced group (55.2 ± 4.8 vs. 42.6 ± 3.8°, p = 0.05). Peak knee extension moments tended to be greater for the experienced group (0.29 ± 0.21 vs. 0.087 ± 0.047 Nm/kg, p = 0.09). This report describes gait changes during the introductory phase of DKBS adoption. Experienced KAFO users undoubtedly had ingrained gait patterns designed to compensate for walking with a standard locked KAFO. These patterns may have limited the ability of those users from taking full and immediate advantage of the SCO capabilities. Also, alternate SCO systems may engender different results. Comparison studies and longer term field studies are needed to clarify benefits of the various bracing options.
KW - Gait
KW - KAFO
KW - Stance control orthosis
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U2 - 10.1080/03093640500238915
DO - 10.1080/03093640500238915
M3 - Article
C2 - 16466156
AN - SCOPUS:30844443684
SN - 0309-3646
VL - 29
SP - 269
EP - 282
JO - Prosthetics and Orthotics International
JF - Prosthetics and Orthotics International
IS - 3
ER -