Biomechanical and energetic effects of a stance-control orthotic knee joint.

Users of traditional knee-ankle-foot orthoses (KAFOs) walk with either locked or unlocked knee joints depending on the level of stability required. Some users may benefit from new stance-control KAFOs that prevent stance-phase knee flexion but allow swing-phase flexion. We collected data from nine nondisabled adults who walked with KAFOs that incorporated the Horton Stance-Control Orthotic Knee Joint (SCOKJ) in the locked, unlocked, and auto (which provides knee stability during stance phase and knee flexion during swing phase) modes to investigate the biomechanical and energetic effects of stance-control orthoses. Studying nondisabled subjects allowed us to analyze the effects of stance-control orthoses in a homogenous population. In general, gait kinematics for the auto and unlocked modes were more similar than for the auto and locked modes. Despite the elimination of hip hiking in the auto mode, oxygen cost was not different between the auto and locked modes (p > 0.99). The SCOKJ allowed our nondisabled subjects to walk with a more normal gait pattern; however, future research should explore the effect of stance-control orthoses on persons with gait pathology.

[1]  Lehmann Jf,et al.  Knee lock device for knee ankle orthoses for spinal cord injured patients: an evaluation. , 1978 .

[2]  R. Waters,et al.  Energy costs of walking in lower-extremity plaster casts. , 1982, The Journal of bone and joint surgery. American volume.

[3]  M P Kadaba,et al.  Measurement of lower extremity kinematics during level walking , 1990, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[4]  L. Broström,et al.  The increase in energy cost of walking with an immobilized knee or an unstable ankle. , 2020, Scandinavian journal of rehabilitation medicine.

[5]  S. Simon.  Gait Analysis, Normal and Pathological Function. , 1993 .

[6]  H J Yack,et al.  The effects of unilateral knee immobilization on lower extremity gait mechanics. , 1995, Medicine and science in sports and exercise.

[7]  Energy-Efficient Knee-Ankle-Foot Orthosis , 1996 .

[8]  R. W. Wirta,et al.  Energy‐Efficient Knee‐Ankle-Foot Orthosis: A Case Study , 1996 .

[9]  O. Kameyama,et al.  Newly designed computer controlled knee-ankle-foot orthosis (Intelligent Orthosis) , 1998, Prosthetics and orthotics international.

[10]  S. Gard,et al.  The influence of stance-phase knee flexion on the vertical displacement of the trunk during normal walking. , 1999, Archives of physical medicine and rehabilitation.

[11]  A. Field.  Discovering statistics using SPSS for Windows. , 2000 .

[12]  P O Riley,et al.  Hip hiking and circumduction: quantitative definitions. , 2000, American journal of physical medicine & rehabilitation.

[13]  D C Kerrigan,et al.  Energy consumption during level walking with arm and knee immobilized. , 2001, Archives of physical medicine and rehabilitation.

[14]  J. Michael,et al.  Preliminary Evidence for Effectiveness of a Stance Control Orthosis , 2004 .

[15]  S. E. Irby,et al.  Gait of stance control orthosis users: The Dynamic Knee Brace System , 2005, Prosthetics and orthotics international.

[16]  Jacqueline S. Hebert,et al.  Gait evaluation of an automatic stance-control knee orthosis in a patient with postpoliomyelitis. , 2005, Archives of physical medicine and rehabilitation.

[17]  Stefania Fatone,et al.  A Review of the Literature Pertaining to KAFOs and HKAFOs for Ambulation , 2006 .