The gait and energy efficiency of stance control knee–ankle–foot orthoses: A literature review

Background: The use of knee–ankle–foot orthoses with drop locked knee joints produces some limitations for walking in subjects with quadriceps muscle weakness. The development of stance control orthoses can potentially improve their functionality. Objectives: The aim of this review was to compare the evidence of the effect of stance control orthoses to knee–ankle–foot orthoses with drop locked knee joints in improving kinematic variables and energy efficiency of walking by subjects with quadriceps muscle weakness caused by different pathologies. Study design: Literature review. Methods: Based on selected keywords and their composition, a search was performed in Google Scholar, PubMed, ScienceDirect, and ISI Web of Knowledge databases. In total, 18 articles were finally chosen for review. Results: The results of this study demonstrated that this type of orthosis can improve the walking parameters of subjects with quadriceps muscle weakness and spinal cord injury patients when compared to a locked knee–ankle–foot orthosis. Conclusion: There is evidence to show that stance control orthosis designs improve the gait kinematics but not energetic of knee–ankle–foot orthosis users. Development of new designs of stance control orthoses to provide a more normal pattern of walking is still required. Clinical relevance Stance control orthoses are a new generation of orthotic intervention that could potentially be significant in assisting to improve the gait kinematics by knee–ankle–foot orthosis users.