title: Foot loading with an ankle-foot orthosis: the accuracy of an integrated physical strain trainer.
abstract: OBJECTIVE
  To investigate the value of a built-in physical strain trainer for the monitoring of partial weight bearing with an ankle-foot orthosis.
  
  
  METHODS
  12 healthy volunteers were asked to perform three trials. Plantar peak pressure values from normal gait (trial one) were defined as 100% (baseline). The following trials were performed with the Vacoped® dynamic vacuum ankle orthosis worn in a neutral position with full weight bearing (trial two) and a restriction to 10% body weight (BW) (trial three), as monitored with an integrated physical strain trainer. Peak plantar pressure values were obtained using the pedar® X system.
  
  
  RESULTS
  Peak pressure values were statistically significantly reduced wearing the Vacoped® shoe with full weight bearing for the hindfoot to 68% of the baseline (normal gait) and for the midfoot and forefoot to 83% and 60%, respectively. Limited weight bearing with 10% BW as controlled by physical strain trainer further reduced plantar peak pressure values for the hindfoot to 19%, for the midfoot to 43% of the baseline and the forefoot to 22% of the baseline.
  
  
  CONCLUSIONS
  The Vacoped® vacuum ankle orthosis significantly reduces plantar peak pressure. The integrated physical strain trainer seems unsuitable to monitor a limitation to 10% BW adequately for the total foot. The concept of controlling partial weight bearing with the hindfoot-addressing device within the orthosis seems debatable but may be useful when the hindfoot in particular must be off-loaded.
authors.affiliation: Division of Orthopedic Rheumatology, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Pauser
authors.forename: Andreas
authors.initials: A
authors.lastname: Jendrissek
authors.forename: Matthias
authors.initials: M
authors.lastname: Brem
authors.forename: Kolja
authors.initials: K
authors.lastname: Gelse
authors.forename: Bernd
authors.initials: B
authors.lastname: Swoboda
authors.forename: Hans-Dieter
authors.initials: HD
authors.lastname: Carl
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000628:therapy*; D000843:Ankle Joint; D005260:Female; D005528:Foot / Q000502:physiology*; D006801:Humans; D008297:Male; D008422:Materials Testing; D009989:Orthotic Devices; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D011312:Pressure; D015203:Reproducibility of Results; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology*