Use of Motek Medical CAREN extended to compare the effects of a stance control KAFO in locked and stance modes on walking and tripping

Ross, Karyn (2014) Use of Motek Medical CAREN extended to compare the effects of a stance control KAFO in locked and stance modes on walking and tripping. In: American Orthotic and Prosthetic Association, 2014-09-04 - 2014-09-07, Nevada. (Unpublished)

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Stance control knee-ankle-foot orthoses (SCO) are prescribed for people with quadriceps insufficiency to provide stability of the limb during stance phase but to enable knee flexion during swing phase thereby facilitating a more normal gait pattern. ‘Standard’ locked knee-ankle-foot orthoses (KAFO) have been shown to cause unsightly gait compensations (ipsilateral hip hiking and circumduction, and contralateral vaulting) to reduce the likelihood of tripping as well as having a negative impact on physiological aspects. There is still limited evidence to support the use of SCOs and as the demand for evidence based practice increases, it is of vital importance that all aspects of this technology is monitored and evaluated. The majority of existing research on SCO systems is confined to case studies or case series’. However, there is a trend in the literature which indicates a positive benefit associated with the use of SCOs. This is with respect to: •increased knee flexion during swing phase •decreased compensatory movements (gait deviations) to facilitate swing phase clearance •improved temporal and spatial gait parameters. Many of these studies were conducted in a gait laboratory which provides an ideal but unrealistic walking environment. In particular, the outside environment presents distractions and a variety of terrains which present trip hazards to people wearing locked knee-ankle-foot orthoses. The Motek CAREN (Computer Assisted Rehabilitation ENvironment) system is a unique laboratory configuration which permits biomechanical assessment of human movement to be conducted in a manner not previously available to researchers and academics. The system hardware comprises a 6 degrees-of-freedom motion platform, a dual belt force instrumented treadmill, a motion capture system, and a large diameter 180° projection screen for displaying virtual reality environments to participants and the provision of biofeedback. The system also permits fully instrumented 3D biomechanical motion analysis of the walking participant. Specifically, the study aimed to investigate in normal subjects the differences in gait and the incidence of tripping while wearing a SCO in locked and stance modes. This pilot study also aimed to develop a test protocol which could then be used for patient testing.


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