Highlights
- •Early and continuous use of night ankle-foot orthoses apparently minimized spatiotemporal and kinematic compensations.
- •Night ankle–foot orthoses can induce positive changes in gait when used before the advance of functional deficit.
- •Day and night ankle–foot orthoses use be prescribed early on and maintained during the course of the disease.
Abstract
Background
Orthosis use prevents muscle contracture and prolongs ambulation in patients with
Duchenne muscular dystrophy (DMD). However, its biomechanical effects on gait are
unclear. This study assessed the effects of daytime and night-time use of Articulated
Ankle Foot Orthosis (AFO) on kinematic, kinetic and spatial/temporal gait parameters
of DMD patients.
Methods
Twenty ambulatory patients (4–12 years of age) were assigned to one of three groups: no orthosis (NoO; n = 7), night-time orthosis (NiO; n = 7), day-time orthosis (DO; n = 6). All subjects were evaluated once (Ev1) and five of them were re-evaluated between
five and seven months after Ev1 (Ev2).
Findings
Cross-sectional analysis with linear mixed-effects models (ANOVA) showed increased
peak dorsiflexion angle and dorsiflexor moment and decreased plantar flexion angle
and ankle joint power generation for the DOwith group when compared to the NoO group
(P < 0.05). The DOwith group also showed decreased peak hip flexion angle, hip power absorption,
plantar flexion angle and increased peak dorsiflexion moment when compared to the
NoO group (P < 0.05). Analysis of gait cycle curves showed significant and clinically relevant changes
in kinematic and kinetic parameters for the DOwith group when compared to the other
experimental groups. Longitudinal analysis suggest that night-time use of Articulated
AFO can promote positive changes in gait parameters of DMD patients, when used before
the functional deficit is too advanced.
Interpretation
Early daytime and night-time use of Articulated AFO changed gait and minimized typical
compensations seen in DMD patients, thus it is recommended in order to prolong gait
ability.
Keywords
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Article Info
Publication History
Published online: April 21, 2016
Accepted:
April 12,
2016
Received in revised form:
April 6,
2016
Received:
May 4,
2015
Identification
Copyright
© 2016 Elsevier Ltd. All rights reserved.
