Comparison of five different methodologies for evaluating ankle–foot orthosis stiffness

Journal of NeuroEngineering and Rehabilitation

Research

Elizabeth Russell Esposito¹  Benjamin R. Shuman²  Fan Gao³  Deema Totah⁴  Andrew J. Ries⁵  Deanna H. Gates⁶ 

[1] Center for Limb Loss and Mobility, VA Puget Sound, 1660 S Columbian Way, Seattle, WA, USA;DOD-VA Extremity Trauma and Amputation Center of Excellence (EACE), Joint Base San Antonio Fort Sam Houston, TX, USA;Center for Limb Loss and Mobility, VA Puget Sound, 1660 S Columbian Way, Seattle, WA, USA;The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA;Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA;Department of Mechanical Engineering, University of Iowa, Iowa City, IA, USA;James R. Gage Center for Gait & Motion Analysis, Gillette Children’s Specialty Healthcare, St. Paul, MN, USA;School of Kinesiology, University of Michigan, Ann Arbor, MI, USA;

关键词: Rotational stiffness;    Mechanical testing;    Bench testing;    Methods comparison;    Carbon fiber;    Stiffness measurement;    Testing standards;    Exoskeleton;   

DOI  :  10.1186/s12984-023-01126-7

 received in 2022-01-07, accepted in 2023-01-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe mechanical properties of an ankle–foot orthosis (AFO) play an important role in the gait mechanics of the end user. However, testing methodologies for evaluating these mechanical properties are not standardized.The purpose of this study was to compare five different evaluation frameworks to assess AFO stiffness.MethodThe same 13 carbon composite AFOs were tested with five different methods. Four previously reported custom test fixtures (the BRUCE, KST, SMApp, and EMPIRE) rotated an AFO into dorsiflexion about a defined axis in the sagittal plane. The fifth method involved quasi-static deflection of AFOs into dorsiflexion by hanging weights (HW) from the footplate. AFO rotational stiffness was calculated as the linear fit of the AFO resistive torque and angular deflection. Differences between methods were assessed using descriptive statistics and a repeated measures Friedman with post-hoc Bonferroni–Holm adjusted Wilcoxon signed-rank tests.ResultsThere were significant differences in measured AFO stiffnesses between test methods. Specifically, the BRUCE and HW methods measured lower stiffness than both the EMPIRE and the KST. Stiffnesses measured by the SMApp were not significantly different than any test method. Stiffnesses were lowest in the HW method, where motion was not constrained to a single plane. The median difference in absolute AFO stiffness across methods was 1.03 Nm/deg with a range of [0.40 to 2.35] Nm/deg. The median relative percent difference, measured as the range of measured stiffness from the five methods over the average measured stiffness was 62% [range 13% to 156%]. When the HW method was excluded, the four previously reported test fixtures produced a median difference in absolute AFO stiffness of 0.52 [range 0.38 to 2.17] Nm/deg with a relative percent difference between the methods of 27% [range 13% to 89%].ConclusionsThis study demonstrates the importance of developing mechanical testing standards, similar to those that exist for lower limb prosthetics. Lacking standardization, differences in methodology can result in large differences in measured stiffness, particularly for different constraints on motion. Non-uniform measurement practices may limit the clinical utility of AFO stiffness as a metric in AFO prescription and future research.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

41116_2022_35_Article_IEq377.gif

41116_2022_35_Article_IEq373.gif

Fig. 2

41116_2022_35_Article_IEq364.gif

41116_2022_35_Article_IEq360.gif

41116_2022_35_Article_IEq357.gif

41116_2022_35_Article_IEq354.gif

41116_2022_35_Article_IEq351.gif

41116_2022_35_Article_IEq349.gif

41116_2022_35_Article_IEq346.gif

41116_2022_35_Article_IEq343.gif

41116_2022_35_Article_IEq340.gif

41116_2022_35_Article_IEq337.gif

41116_2022_35_Article_IEq336.gif

41116_2022_35_Article_IEq335.gif

41116_2022_35_Article_IEq333.gif

Fig. 2

Fig. 1

41116_2022_35_Article_IEq297.gif