Article

Objective: To determine gait differences in a subject ambulating with a knee-ankle-foot orthosis (KAFO) with a locked knee joint versus an automatic stance-control knee joint. Design: Single-subject crossover design. Setting: Tertiary rehabilitation facility with a motion analysis laboratory. Participant: A 61-year-old ambulatory male volunteer with postpoliomyelitis walking with a stance-control KAFO. Interventions: Instrumented gait analysis and Physiological Cost Index in the locked knee and stance-control modes. Main Outcome Measure: Differences in gait parameters. Results: On the braced limb, stance-control mode showed a near-normal knee flexion wave in swing, reduced pelvic retraction and rotational excursion, and improved hip power generation. On the nonbraced limb, the stance-control mode allowed elimination of vaulting, reduction in abnormal ankle and hip power generation, increased knee power absorption, and more typical quadriceps activation. There was a trend toward improved energy efficiency in the stance-control mode. Conclusions: Use of a stance-control knee joint in a KAFO appears to improve gait biomechanics and improve energy efficiency compared with a locked knee.(c) 2005 by American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.

Langue : ANGLAIS