title: Effects of a dynamic-ankle-foot orthosis (Liberté®) on kinematics and electromyographic activity during gait in hemiplegic patients with spastic foot equinus.
abstract: BACKGROUND
  A dynamic-ankle-foot orthosis has recently emerged and consists of an elastic band allowing the variation of stiffness degree and adjusts dorsiflexion assistance in swing. The aim of this study was to quantify the biomechanical adaptations induced by this orthosis during gait in hemiplegic patients.
  
  
  METHODS
  Twelve hemiplegic patients performed two gait analyses (without and with the ankle-foot orthosis). Spatiotemporal, kinematic, kinetic and electromyographic gait parameters were quantified using an instrumented gait analysis system during the stance and swing phases.
  
  
  RESULTS
  During swing, peak ankle dorsiflexion was greater with the orthosis and associated with a decrease of pelvic obliquity angle. In stance, peak ankle plantarflexion and dorsiflexion were greater with the orthosis and associated with an increase of ankle angle at heel strike and toe-off. Electromyographic activities of both the tibialis anterior and the medial gastrocnemius were greater with the orthosis.
  
  
  CONCLUSIONS
  This dynamic-ankle-foot orthosis improved gait in hemiplegic patients with spastic foot equinus. The spatiotemporal adaptations seem to be caused mainly by the increase of ankle dorsiflexion during stance and swing phases. The changes in electromyographic activity were related to an active dorsiflexion in stance and swing phases and an active plantarflexion in stance phase.
authors.affiliation: Groupement de Recherche Clinique et Technologique sur le Handicap (EA 4497), CIC-IT 805, CHU Raymond Poincaré, Garches, France.
authors.forename: J
authors.initials: J
authors.lastname: Boudarham
authors.affiliation: Groupement de Recherche Clinique et Technologique sur le Handicap (EA 4497), CIC-IT 805, CHU Raymond Poincaré, Garches, France.
authors.forename: D
authors.initials: D
authors.lastname: Pradon
authors.affiliation: Groupement de Recherche Clinique et Technologique sur le Handicap (EA 4497), CIC-IT 805, CHU Raymond Poincaré, Garches, France.
authors.forename: N
authors.initials: N
authors.lastname: Roche
authors.affiliation: Groupement de Recherche Clinique et Technologique sur le Handicap (EA 4497), CIC-IT 805, CHU Raymond Poincaré, Garches, France.
authors.forename: D
authors.initials: D
authors.lastname: Bensmail
authors.affiliation: Groupement de Recherche Clinique et Technologique sur le Handicap (EA 4497), CIC-IT 805, CHU Raymond Poincaré, Garches, France Laboratory of Human Motricity, Sport, Education and Health (EA 6309), University of Nice Sophia Antipolis, France.
authors.forename: R
authors.initials: R
authors.lastname: Zory
mesh_terms: D000842:Ankle / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D004576:Electromyography; D004863:Equinus Deformity / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation*; D005260:Female; D005528:Foot / Q000503:physiopathology*; D061826:Foot Orthoses; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology; D016896:Treatment Outcome
keywords: Foot deformity; dynamic ankle-foot-orthosis; kinematic; muscular activity