The effect of custom-made braces for the ankle and hindfoot on ankle and foot kinematics and ground reaction forces.
OBJECTIVE
To assess the effects on gait of custom-made polypropylene orthoses: ankle-foot orthosis (AFO), rigid hindfoot orthosis (HFO-R), and articulated hindfoot orthosis (HFO-A).


METHODS
Experimental assessment.


METHODS
Institutional practice, motion analysis laboratory.


METHODS
Twenty asymptomatic normative subjects.


METHODS
Not applicable.


METHODS
Three-dimensional kinematics, ground reaction force, and time-related factors in 4 conditions: shoe only, and shod with the AFO, HFO-R, and HFO-A.


RESULTS
The AFO and HFO-R limited sagittal and coronal plane ankle-hindfoot motion. The HFO-A limited hindfoot coronal motion while allowing normal sagittal motion. At the midfoot, the AFO and HFO-A limited transverse motion, but the HFO-A also limited sagittal and coronal motion. Use of the HFO-R resulted in exaggerated midfoot sagittal and coronal motion. Braces that limited motion to a greater degree were associated with more atypical kinetic variables, indicative of less dynamic gait. The HFO-A resulted in ground reaction forces most similar to unbraced conditions.


CONCLUSIONS
Alteration in gait was affected by orthosis design. Orthoses with a rigid component crossing a joint restricted motion at that joint, but potentially compromised typical gait kinetic factors. For immobilizing the hindfoot, the HFO-A may be more comfortable and still provide more stability than the HFO-R or AFO.
Kitaoka
Harold B
HB
Department of Orthopaedic Surgery, Mayo Clinic Rochester, MN 55905, USA. kitaoka.harold@mayo.edu
Crevoisier
Xavier M
XM
Harbst
Kimberly
K
Hansen
Diana
D
Kotajarvi
Brian
B
Kaufman
Kenton
K
D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000502:physiology*; D001696:Biomechanical Phenomena; D001915:Braces; D015331:Cohort Studies; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005528:Foot / Q000502:physiology*; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D016059:Range of Motion, Articular / Q000502:physiology; D012016:Reference Values; D012680:Sensitivity and Specificity; D013314:Stress, Mechanical; D016474:Weight-Bearing