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Restricting ankle motion via orthotic bracing reduces toe clearance when walking over obstacles

Evangelopoulou, E, Twiste, M and Buckley, J 2015, 'Restricting ankle motion via orthotic bracing reduces toe clearance when walking over obstacles' , Gait & Posture . (In Press)

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Background: When trans-tibial amputees cross obstacles leading with their prosthesis, foot clearance is achieved using compensatory swing-phase kinematics. Such compensation would suggest able-bodied individuals normally use swing-phase ankle dorsiflexion to attain adequate obstacle clearance, however, direct evidence of such contribution is equivocal. The present study determined the contribution of sagittal plane ankle motion in achieving lead-limb clearance during obstacle negotiation. Methods: 12 male able-bodied individuals (ages 18-30) completed obstacle crossing trials while walking on a flat surface. Lead-limb (right) ankle motion was manipulated using a knee-ankle-foot orthosis. Trials were completed with the ankle restricted at a neutral angle or unrestricted (allowing ~ ±15 plantar/dorsiflexion). Findings: Restricted ankle motion caused significant increase in trail-limb foot placement distance before the obstacle (p=0.005); significant decrease in vertical toe clearance (p<0.003), vertical heel clearance (p=0.045) and lead-limb foot placement distance after the obstacle (p=0.045); but no significant changes in knee angle at instant of crossing or in average walking speed. Interpretation: The shifts in foot placements altered the part of swing that the lead-limb was in when the foot crossed the obstacle, which led to a decrease in clearance. These adaptations may have been due to being unable to dorsiflex the ankle to ‘lift’ the toes in mid-swing or to being unable to plantarflex the ankle during initial contact following crossing, which changed how the lead-limb was to be loaded. These findings suggest individuals using ankle bracing or those with ankle arthrodesis, will have reduced gait safety when negotiating obstacles.

Item Type: Article
Schools: Schools > School of Health Sciences > Centre for Health Sciences Research
Journal or Publication Title: Gait & Posture
Publisher: Elsevier
ISSN: 0966-6362
Funders: Non funded research
Depositing User: M Twiste
Date Deposited: 08 Dec 2015 09:16
Last Modified: 13 May 2016 07:27

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