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Zhou Y. Recent advances in wearable actuated ankle-foot orthoses: Medical effects, design, and control. Proc Inst Mech Eng H 2023; 237:163-178. [PMID: 36515408 DOI: 10.1177/09544119221142335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This paper presents a survey on recent advances of wearable actuated ankle-foot orthoses (AAFOs). First of all, their medical functions are investigated. From the short-term aspect, they lead to rectification of pathological gaits, reduction of metabolic cost, and improvement of gait performance. After AAFO-based walking training with sufficient time, free walking performance can be enhanced. Then, key design factors are studied. First, primary design parameters are investigated. Second, common actuators are analysed. Third, human-robot interaction (HRI), ergonomics, safety, and application places, are considered. In the following section, control technologies are reviewed from the aspects of rehabilitation stages, gait feature quantities, and controller characteristics. Finally, existing problems are discussed; development trends are prospected.
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Affiliation(s)
- Yuan Zhou
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, China
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Zhou C, Yang Z, Li K, Ye X. Research and Development of Ankle-Foot Orthoses: A Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22176596. [PMID: 36081055 PMCID: PMC9460335 DOI: 10.3390/s22176596] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/28/2022] [Accepted: 08/29/2022] [Indexed: 05/14/2023]
Abstract
The ankle joint is one of the important joints of the human body to maintain the ability to walk. Diseases such as stroke and ankle osteoarthritis could weaken the body's ability to control joints, causing people's gait to be out of balance. Ankle-foot orthoses can assist users with neuro/muscular or ankle injuries to restore their natural gait. Currently, passive ankle-foot orthoses are mostly designed to fix the ankle joint and provide support for walking. With the development of materials, sensing, and control science, semi-active orthoses that release mechanical energy to assist walking when needed and can store the energy generated by body movement in elastic units, as well as active ankle-foot orthoses that use external energy to transmit enhanced torque to the ankle, have received increasing attention. This article reviews the development process of ankle-foot orthoses and proposes that the integration of new ankle-foot orthoses with rehabilitation technologies such as monitoring or myoelectric stimulation will play an important role in reducing the walking energy consumption of patients in the study of human-in-the-loop models and promoting neuro/muscular rehabilitation.
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Affiliation(s)
- Congcong Zhou
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou 310016, China
- Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China
| | - Zhao Yang
- Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China
| | - Kaitai Li
- Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China
| | - Xuesong Ye
- Key Laboratory for Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China
- Correspondence:
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Xu R, Zuo H, Ji Y, Li Q, Wang Z, Liu H, Wang J, Wei Z, Li W, Cong L, Li H, Jin H, Wang J. Effects of Short-Term Limitation of Movement of the First Metatarsophalangeal Joint on the Biomechanics of the Ipsilateral Hip, Knee, and Ankle Joints During Walking. Med Sci Monit 2021; 27:e930081. [PMID: 33664219 PMCID: PMC7941761 DOI: 10.12659/msm.930081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND We analyzed the effect of limitation of movement of the first metatarsophalangeal joint (FMJ) on the biomechanics of the lower limbs during walking. MATERIAL AND METHODS Eight healthy college students completed walking under barefoot (BF) and FMJ constraint (FMJC) conditions. We synchronously collected kinematics and dynamics data, and calculated the torque, power, and work of hip, knee, and ankle joints. RESULTS Compared with normal conditions, when the FMJ is restricted from walking, the maximum ankle dorsiflexion angle is significantly increased (P<0.001), the maximum plantar flexion angle is significantly reduced (P<0.001), the maximum plantar flexion torque (P<0.001) and the maximum dorsiflexion torque (P<0.05) increased significantly, the maximum power increased significantly (P<0.001), the minimum power decreased significantly (P<0.001), and the negative work increased significantly (P<0.001). The torque of hip and knee joints increased significantly (P<0.05). CONCLUSIONS After the movement of the FMJ is restricted, the human body mainly compensates and transfers compensation by increasing the angle of dorsiflexion, increasing work and the activity level of surrounding muscles through the ankle joint, thereby increasing the torque load of the knee and hip joints to maintain the dynamic balance of kinematics. FMJC condition increases the energy consumption of the human ankle, knee, and hip joints during walking. The load is compensated by the gradual attenuation of the ankle, knee, and hip. Long-term limitation may cause damage to the posterior calf muscles and increase the incidence of knee arthritis.
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Affiliation(s)
- Rui Xu
- Department of Endocrinology, Shanghai National Research Center for Endocrine and Metabolic Disease, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Disease, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (mainland).,Department of Clinical Medicine, Norman Bethune Health Science Center of Jilin University, Changchun, Jilin, China (mainland)
| | - Hao Zuo
- Department of Pain, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Youbo Ji
- Department of Pain, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Qiang Li
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Zhonghan Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - He Liu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Jiarui Wang
- Department of Clinical Medicine, Norman Bethune Health Science Center of Jilin University, Changchun, Jilin, China (mainland)
| | - Zheyi Wei
- Department of Clinical Medicine, Fudan University School of Medicine, Shanghai, China (mainland)
| | - Weihang Li
- Department of Orthopaedics, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, China (mainland)
| | - Lin Cong
- Department of Bioengineering, School of Public Health, Jilin University, Changchun, Jilin, China (mainland)
| | - Han Li
- Department of Clinical Medicine, Norman Bethune Health Science Center of Jilin University, Changchun, Jilin, China (mainland)
| | - Hui Jin
- Department of Pain, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Jincheng Wang
- Orthopaedic Medical Centre, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
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Kim JH, Won BH. Kinematic on Ankle and Knee Joint of Post-Stroke Elderly Patients by Wearing Newly Elastic Band-Type Ankle-Foot Orthosis in Gait. Clin Interv Aging 2019; 14:2097-2104. [PMID: 31824140 PMCID: PMC6901042 DOI: 10.2147/cia.s222087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 11/14/2019] [Indexed: 12/31/2022] Open
Abstract
Purpose The post-stroke elderly was increased caused by increasing stroke and advanced medical. However, ankle–foot orthoses (AFOs) can be uncomfortable for hemiplegic patients; therefore, the usability is not good. In this study, we analyzed ankle and knee joint angles in post-stroke elderly patients to assess the functional effectiveness (specifically prevention of back knee and drop-foot) of a new elastic band-type AFO (New Product: NP) during gait. Patients and methods Nine elderly post-stroke patients (eight males, one female; 55.7±8.4 years; 165.8±9.2 cm; 68.8±11.5 kg; five with right hemiplegia, four with left hemiplegia; onset period: 6.6 years) were selected for participation in this study. We captured gait motion using 12 cameras (MX-T20, Vicon, Inc., Oxford, UK) under three different conditions [wearing nothing (WI), using existing ordinary AFOs made from hard plastic material (EP), and using NP]. The angle variation and maximum–minimum angle of the lower body joints were analyzed during dorsi-plantar flexion of the ankle joint and flexion–extension of knee joint. A one-way ANOVA test for multiple comparisons was performed, followed by a Tukey’s b test to identify statistical significance, which was set at 0.005. Results Regarding the ankle joint, the maximum plantar flexion (drop-foot) value decreased with the NP, and the maximum dorsiflexion value increased. Regarding the knee joint, the maximum extension (back knee) value decreased, and the maximum flexion value increased (p < 0.005). Conclusion Using analysis of the kinematics of the ankles and knees during walking, this research confirmed the effectiveness of the NP, an elastic band-type AFO, for use in ordinary post-stroke elderly patients.
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Affiliation(s)
- Jong Hyun Kim
- Biomedical System & Technology Group, Korea Institute of Industrial Technology, Cheonan, Chungnam, South Korea
| | - Byeong Hee Won
- Biomedical System & Technology Group, Korea Institute of Industrial Technology, Cheonan, Chungnam, South Korea
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