A team of researchers conducted a study to assess the effects of articulated AFO usage among children with Duchenne muscular dystrophy (DMD), and found that daytime and nighttime use of the AFOs changed gait and minimized typical compensations seen in this patient population. The authors of the study, published in the June issue of Clinical Biomechanics, concluded that use of articulated AFOs is recommended to prolong gait ability among this population.
The researchers assigned 20 ambulatory patients who were 4-12 years old to one of three groups: no orthosis (NoO; n=7), nighttime orthosis (NiO; n=7), or daytime orthosis (DO; n=6). Each subject’s kinematic, kinetic, and spatial/temporal gait parameters were evaluated once and five of them were reevaluated between five and seven months later. According to the study, cross-sectional analysis with linear mixed-effects models showed increased peak dorsiflexion angles and dorsiflexor moments, and decreased plantarflexion angles and ankle joint power generation for the DO group when compared to the NoO group.
The DO group also showed decreased peak hip flexion angles, hip power absorption, and plantarflexion angles, and increased peak dorsiflexion moments when compared to the NoO group. Analysis of gait cycle curves showed significant and clinically relevant changes in kinematic and kinetic parameters for the DO group when compared to the other experimental groups. Longitudinal analysis suggested that nighttime use of articulated AFOs can promote positive changes in gait parameters of patients with DMD when used before the functional deficit is too advanced, wrote the authors.
