Design and preliminary evaluation of a new ankle foot orthosis on kinetics and kinematics parameters for multiple sclerosis patients

Abstract

Background: The damage of the central nervous system due to Multiple Sclerosis (MS) leads to many walking disorders in this population. However, current ankle-foot orthoses prescribed for improving walking disorders for these patients are not clinically cost-efficient. Objective: This study aimed to design and fabricate a dynamic ankle foot orthosis and a new spring-damper joint mechanism that could adapt the walking problems of MS patients and evaluate the immediate effect of the new orthosis on the speed, range of motion, moment, total work and ground reaction force during walking. Material and Methods: In this case-series study, after the design and fabrication of a new orthosis, the kinetics and kinematics of walking of four patients with MS were assessed in a case series study. Results: Walking speed improved with the new orthosis in two participants. The sagittal range of motion (ROM) increased for most of the participants. The sagittal moments increased for hip, knee and ankle joints in most of the measurements. The total joint work showed noticeable difference in the ankle joint. The increased values of vertical component of the ground reaction force (VGRF) were negligible and the increase in the impulse of VGRF was noticeable for only one participant. Conclusion: The new orthosis had positive effects kinetic and kinematic parameters of walking such as the increased velocity by two subjects and also a more normal sagittal ROM, moment and work, suggesting the potential usefulness of the new orthotic device for MS population.