Abstract
Objective
To compare the metabolic demands of walking in individuals with lower limb injury
with and without ankle–foot orthosis (AFO) use. A secondary aim was to compare these
results with those from individuals with unilateral transtibial amputation (TTA) and
able-bodied controls.
Design
Cross-sectional study.
Setting
Two clinical research centers.
Participants
Thirteen individuals (N=13) with lower limb injury who used a passive-dynamic AFO
underwent metabolic analysis at 3 standardized speeds with and without their AFO.
Results were compared with individuals with unilateral TTA who used a passive prosthetic
foot and able-bodied controls with no musculoskeletal, neurologic, or cardiovascular
deficits.
Main Outcome Measures
Oxygen consumption, heart rate, and rating of perceived exertion.
Results
The use of the passive-dynamic AFO did not significantly change energetic demand (oxygen
consumption, heart rate, perceived exertion) in participants with a lower limb [LL]
injury. Heart rate (P<.037) was significantly greater than able-bodied controls, but perceived exertion
was significantly lower (P≤.031). There were no significant differences between participants with an LL injury
(with or without the AFO) and individuals with TTA.
Conclusions
Many individuals with LL injuries may expect to use passive-dynamic AFOs with little
to no metabolic consequence. The stabilizing and assistive benefits of the AFO likely
balance with its well-known range of motion limitations and power reductions. Passive-dynamic
AFO use can sometimes be an alternative for individuals considering TTA. These results
support that AFO users may be able to achieve similar energetic demands as those with
amputation.
Keywords
List of abbreviations:
AFO (ankle foot orthosis), LL (lower limb), RPE (rating of perceived exertion), TTA (transtibial amputation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 18, 2022
Accepted:
February 23,
2022
Received in revised form:
February 1,
2022
Received:
July 16,
2021
Footnotes
The data used in this analysis were from projects funded by the Telemedicine and Advanced Technology Research Center (TATRC) at the United States Army Medical Research and Materiel Command through the AMEDD Advanced Medical Technology Initiative (AAMTI), Bethesda, MD. Grant Number: W911QY-15-1-0015.
Disclosures: none.
Identification
Copyright
© 2022 by the American Congress of Rehabilitation Medicine.
