Biomechanics Research Today is a free monthly online journal that collates and summarizes the latest research about Biomechanics, including details on mechanics of living organisms, movement, locomotion, prosthetic limbs.

The effect of custom-made braces for the ankle and hindfoot on ankle and foot kinematics and ground reaction forces.

Kitaoka HB, Crevoisier XM, Harbst K, Hansen D, Kotajarvi B, Kaufman K

Department of Orthopaedic Surgery, Mayo Clinic Rochester, MN 55905, USA. kitaoka.harold@mayo.edu

OBJECTIVE: To assess the effects on gait of custom-made polypropylene orthoses: ankle-foot orthosis (AFO), rigid hindfoot orthosis (HFO-R), and articulated hindfoot orthosis (HFO-A). DESIGN: Experimental assessment. SETTING: Institutional practice, motion analysis laboratory. PARTICIPANTS: Twenty asymptomatic normative subjects. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Three-dimensional kinematics, ground reaction force, and time-related factors in 4 conditions: shoe only, and shod with the AFO, HFO-R, and HFO-A. RESULTS: The AFO and HFO-R limited sagittal and coronal plane ankle-hindfoot motion. The HFO-A limited hindfoot coronal motion while allowing normal sagittal motion. At the midfoot, the AFO and HFO-A limited transverse motion, but the HFO-A also limited sagittal and coronal motion. Use of the HFO-R resulted in exaggerated midfoot sagittal and coronal motion. Braces that limited motion to a greater degree were associated with more atypical kinetic variables, indicative of less dynamic gait. The HFO-A resulted in ground reaction forces most similar to unbraced conditions. CONCLUSIONS: Alteration in gait was affected by orthosis design. Orthoses with a rigid component crossing a joint restricted motion at that joint, but potentially compromised typical gait kinetic factors. For immobilizing the hindfoot, the HFO-A may be more comfortable and still provide more stability than the HFO-R or AFO.

Published 10 January 2006 in Arch Phys Med Rehabil, 87(1): 130-5.
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