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Effects of ankle-foot orthoses on ankle and foot kinematics in patient with ankle osteoarthritis.

Huang YC, Harbst K, Kotajarvi B, Hansen D, Koff MF, Kitaoka HB, Kaufman KR

Orthopedic Motion Analysis Laboratory, Division of Orthopedic Research, Mayo Clinic, Rochester, MN 55905, USA.

OBJECTIVE: To determine if different foot orthoses have a similar effect on foot kinematics in subjects with ankle osteoarthritis (OA) when walking on various ground conditions. DESIGN: Within-subject comparisons study. SETTING: Biomechanics research laboratory. PARTICIPANTS: Thirteen subjects with unilateral ankle OA. INTERVENTIONS: Custom-made ankle-foot orthosis (AFO), rigid hindfoot orthosis (HFO-R), and articulated hindfoot orthosis (HFO-A) were used by subjects when walking on level, ascending and descending ramp, and side-slope conditions. MAIN OUTCOME MEASURES: The range of motion of the hindfoot (calcaneus relative to tibia) and forefoot (metatarsal relative to calcaneus) was measured using an 8-camera motion analysis system. RESULTS: The AFO and HFO-R provided the best sagittal plane hindfoot motion restriction over all ground conditions (P<.001). The HFO-R allowed the greatest sagittal plane forefoot motion when walking over level (P=.01) and side-slope (P<.02) conditions, the greatest frontal plane forefoot motion walking down the ramp (P=.003), and the greatest transverse plane forefoot motion when walking over level (P=.011) and ramp-ascending conditions (P=.005). The HFO-A restricted motion of the unaffected joint and did not effectively restrict hindfoot motion. CONCLUSIONS: The HFO-R not only provides selective restriction to the ankle-hindfoot motion, but also allows sufficient forefoot motion compared with the AFO. We consider the HFO-R to be the best option of all tested orthoses for treating patients with ankle OA pain arising from ankle motion.

Published 25 April 2006 in Arch Phys Med Rehabil, 87(5): 710-6.
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