Thesis

"Shank angle to floor" measures and tuning of "ankle-foot orthosis footwear combinations" for children with cerebral palsy, spina bifida and other conditions

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Awarding institution
  • University of Strathclyde
Date of award
  • 2004
Thesis identifier
  • T11732
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Abstract
  • The purpose of this study is to report the Shank Angle to Floor (SAF) measures of the tuned Ankle-Foot Orthosis Footwear Combination (AFOFC) prescriptions for a population of children with CP, SB and other conditions in North West Wales. It also presents an unambiguous and clearly defined terminology to describe some of the key sagittal plane features of AFOFC prescriptions and methods of measuring them. The thesis includes an extensive literature review on AFOFCs and "tuning". Seventy-four children (Cerebral Palsy n=50, Spina Bifida n=4, Other conditions n=20) who were independently ambulant without walking aids and using solid AFOFCs (n=112) had their prescriptions tuned on a Video Vector Generator Gait Laboratory. Children's gait was analysed while walking barefoot, in footwear and in AFOFCs until they were tuned. The results showed that whether the Angle of The Ankle in the AFO (AAAFO) was dorsiflexed, plantigrade or plantarflexed the SAFs of the tuned AFOFCs were all inclined. For all AFOFCs (n=112) mean SAF=11.36°, SD=2.08, range 7-15°. For AFOFCs used by children with CP (n=69), mean SAF=11.86°, SD=2.05, range 7-15°. For AFOFCs used by children with SB (n=8), mean = 7.75°, SD=0.46, range 7-8°. AFOFCs for other children (n=35), mean =11.2°, SD=1.41, range 8-14°. The results suggest that when tuning AFOFCs a good starting point would be to set the SAF at 10-12° inclined and increase or decrease the SAF as required. The mean tuned SAFs approximate to the SAF of normal gait at midstance. A possible explanation for the 10-12° inclined SAF being central to the production of stability in stance in both normal and pathological gait with AFOFCs is that it is determined by anthropometric measures.10-12° inclined is the position which brings the centre of the knee joint directly over the middle of the foot. Other design features of the AFOFC to be considered, if it is to be tuned optimally for the whole of the gait cycle, are described. Knowledge of normal and abnormal shank kinematics, throughout the gait cycle is vital for a comprehensive understanding of AFOFC tuning. These are described and discussed.
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DOI
Date Created
  • 2004
Former identifier
  • 747512

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