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

Evangelopoulou, E, Twiste, M ORCID: https://orcid.org/0000-0003-2724-3283 and Buckley, J 2016, 'Restricting ankle motion via orthotic bracing reduces toe clearance when walking over obstacles' , Gait & Posture, 43 , pp. 251-256.

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Abstract

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 and Society > Centre for Health Sciences Research
Journal or Publication Title:	Gait & Posture
Publisher:	Elsevier
ISSN:	0966-6362
Related URLs:	Publication
Funders:	Non funded research
Depositing User:	M Twiste
Date Deposited:	08 Dec 2015 09:16
Last Modified:	15 Feb 2022 19:52
URI:	https://usir.salford.ac.uk/id/eprint/36937

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