Poster 1: Joint and Clinical Studies

Zahra McKee, Jacob Skigen, Darcy Reisman, Elisa Arch

University of Delaware

To supplement post-stroke muscle weakness, passive dynamic ankle-foot orthoses (PD-AFOs) provide dynamic levels of rotational spring-like assistance about the ankle joint. This case study aimed to investigate if physical therapy training could improve a patient’s loading of the PD-AFO and if so, if enhanced walking function followed. The participant was a 72-year-old male 8 years post-stroke. They participated in 5 physical therapy sessions, focused on increasing midstance dorsiflexion on the PD-AFO (paretic) side to engage the rotational spring. Instrumented gait analysis data was collected pre- and post-training at the participant’s pre-training PD-AFO self-selected walking speed. Paretic peak dorsiflexion angle increased 181.7% (Pre: 2.52°, Post: 7.11°), paretic peak plantar flexion moment increased 21.33% (Pre: -0.72 Nm/kg, Post: -0.88 Nm/kg ), and paretic peak positive ankle power increased 51.81% (Pre: 0.19 W/kg, Post: 0.30 W/kg ). Self-selected walking speed was virtually unchanged (Pre: 0.32 m/s, Post: 0.35 m/s) and total mechanical cost of transport increased by 10% (Pre: 1.88 J/kg/m, Post: 2.07 J/kg/m). Training resulted in meaningful improvements in ankle biomechanics, but these did not translate to enhanced walking function.

Research Area: Rehabilitation & Treatment