Effects of orthoses on muscle activity and synergy during gait

An orthosis is often used in rehabilitation to improve kinetic and kinematic parameters during gait. However, whether changes in neural control depend on wearing an orthosis during gait is unclear. We measured the muscle activity and synergy of the lower limb muscles without orthosis and with two types of orthoses: ankle–foot orthosis (AFO) and knee–ankle–foot orthosis (KAFO). Muscle activity during gait was measured in 15 healthy adults, and muscle synergies were extracted using non-negative matrix factorization. The results revealed that some muscle activities were significantly different among the three conditions. Post-hoc analysis indicated differences between each condition. Knee extensor muscle activity related to the loading response was significantly increased by wearing the AFO. In the KAFO condition, hip abductor muscle activity related to weight bearing was significantly decreased, and ankle dorsiflexor muscle activity was increased to secure clearance during the swing phase. However, the number of muscle synergies and complexity of muscle synergy did not significantly change among these conditions. However, along with changes in muscle activity, the activation pattern and weightings of muscle synergies tended to change with the use of orthoses. Each muscle activity was changed by wearing the orthosis; however, the immediate mechanical constraint did not change the framework of muscle synergy.

[1]  M. Schwartz,et al.  Synergies analysis produces consistent results between motion analysis laboratories. , 2021, Gait & posture.

[2]  N. Ogihara,et al.  Effect of ankle-foot orthosis on level walking in healthy subjects , 2019, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[3]  Masataka Yamamoto,et al.  Estimation of knee joint reaction force based on the plantar flexion resistance of an ankle-foot orthosis during gait , 2018, Journal of physical therapy science.

[4]  Katherine M Steele,et al.  Motor modules during adaptation to walking in a powered ankle exoskeleton , 2018, Journal of NeuroEngineering and Rehabilitation.

[5]  Takehiko Doi,et al.  Development and validity of methods for the estimation of temporal gait parameters from heel-attached inertial sensors in younger and older adults. , 2017, Gait & posture.

[6]  M. Arazpour,et al.  Efficacy of ankle foot orthoses types on walking in children with cerebral palsy: A systematic review. , 2017, Annals of physical and rehabilitation medicine.

[7]  Katherine M Steele,et al.  Muscle recruitment and coordination with an ankle exoskeleton. , 2017, Journal of biomechanics.

[8]  Toshio Moritani,et al.  Comparison of muscle synergies for running between different foot strike patterns , 2017, PloS one.

[9]  A. Booth,et al.  Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis. , 2016, Health technology assessment.

[10]  J. Ellrich,et al.  Inhibition of soleus Hoffmann reflex by ankle–foot orthosis application in healthy volunteers , 2015, Prosthetics and orthotics international.

[11]  Michael H Schwartz,et al.  The Efficacy of Ankle‐Foot Orthoses on Improving the Gait of Children With Diplegic Cerebral Palsy: A Multiple Outcome Analysis , 2015, PM & R : the journal of injury, function, and rehabilitation.

[12]  J. Romkes,et al.  Immediate effects of unilateral restricted ankle motion on gait kinematics in healthy subjects. , 2015, Gait & posture.

[13]  Richard R Neptune,et al.  The influence of solid ankle-foot-orthoses on forward propulsion and dynamic balance in healthy adults during walking. , 2014, Clinical biomechanics.

[14]  A. Behrman,et al.  Phase dependent modulation of soleus H-reflex in healthy, non-injured individuals while walking with an ankle foot orthosis. , 2014, Gait & posture.

[15]  C. Nester,et al.  A systematic review and meta-analysis of the effect of an ankle-foot orthosis on gait biomechanics after stroke , 2013, Clinical rehabilitation.

[16]  A. d’Avella,et al.  Locomotor Primitives in Newborn Babies and Their Development , 2011, Science.

[17]  S. Collins,et al.  The effect of ankle foot orthosis stiffness on the energy cost of walking: a simulation study. , 2011, Clinical biomechanics.

[18]  Dario Farina,et al.  Impulses of activation but not motor modules are preserved in the locomotion of subacute stroke patients. , 2011, Journal of neurophysiology.

[19]  Joanne K Gronely,et al.  Effect of AFO Design on Walking after Stroke: Impact of Ankle Plantar Flexion Contracture , 2010, Prosthetics and orthotics international.

[20]  Richard R Neptune,et al.  Merging of healthy motor modules predicts reduced locomotor performance and muscle coordination complexity post-stroke. , 2010, Journal of neurophysiology.

[21]  Richard R Neptune,et al.  Modular control of human walking: a simulation study. , 2009, Journal of biomechanics.

[22]  Francesco Lacquaniti,et al.  Modular Control of Limb Movements during Human Locomotion , 2007, The Journal of Neuroscience.

[23]  Francesco Lacquaniti,et al.  Motor Control Programs and Walking , 2006, The Neuroscientist : a review journal bringing neurobiology, neurology and psychiatry.

[24]  F. Lacquaniti,et al.  Coordination of Locomotion with Voluntary Movements in Humans , 2005, The Journal of Neuroscience.

[25]  W. Kargo,et al.  Early Skill Learning Is Expressed through Selection and Tuning of Cortically Represented Muscle Synergies , 2003, The Journal of Neuroscience.

[26]  F. Lacquaniti,et al.  Temporal components of the motor patterns expressed by the human spinal cord reflect foot kinematics. , 2003, Journal of neurophysiology.

[27]  Emilio Bizzi,et al.  Combinations of muscle synergies in the construction of a natural motor behavior , 2003, Nature Neuroscience.

[28]  H. Sebastian Seung,et al.  Learning the parts of objects by non-negative matrix factorization , 1999, Nature.

[29]  K H Mauritz,et al.  Gait function in spastic hemiparetic patients walking barefoot, with firm shoes, and with ankle‐foot orthosis , 1996, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[30]  J. Perry,et al.  Adaptations during the stance phase of gait for simulated flexion contractures at the knee. , 1994, Orthopedics.

[31]  S. Yamada,et al.  Number of Synergies Is Dependent on Spasticity and Gait Kinetics in Children With Cerebral Palsy , 2018, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[32]  Lena H Ting,et al.  A limited set of muscle synergies for force control during a postural task. , 2005, Journal of neurophysiology.