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A Model to Predict the Effect of Ankle Joint Misalignment on Calf Band Movement in Ankle-Foot Orthoses

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TLDR
In this article, the effects of systematic linear (proximal-distal and anterior-posterior) misalignments of single axis mechanical ankle joints in an ankle-foot orthosis (AFO) were modeled to determine the degree and direction of calf band travel that would occur over a functional range of motion.
Abstract
Accurate alignment of anatomical and mechanical joint axes is one of the major biomechanical principles pertaining to articulated orthoses, yet knowledge of the potential effects of axis misalignment is limited. The purpose of this project was to model the effects of systematic linear (proximal-distal and anterior-posterior) misalignments of single axis mechanical ankle joints in an ankle-foot orthosis (AFO) in order to determine the degree and direction of calf band travel that would occur over a functional range of motion. Sagittal plane misalignments of the ankle joint centres of an AFO were simulated using a simple two-dimensional model for both a range of ankle angles and a typical able-bodied ankle kinematic curve for self-selected normal walking speed. The model assumed that no movement occurred between the foot and the foot-plate of the AFO. The model predicted that for anterior (positive horizontal) misalignments, dorsiflexion movements would cause the calf band to travel proximally (i.e., up the leg) and plantar flexion movements would cause the calf band to travel distally (i.e., down the leg). The opposite was predicted for posterior (negative horizontal) misalignments. Proximal (positive vertical) misalignments would cause only distal movements of the calf band while distal (negative vertical) misalignments would cause only proximal movements of the calf band. Anterior-posterior misalignments were found to have a much larger effect on the amount of calf band travel than proximal-distal misalignments.

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Citations
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Effects of joint alignment and type on mechanical properties of thermoplastic articulated ankle-foot orthosis

TL;DR: The current study suggested that anterior and posterior alignment be avoided as much as possible in clinical practice due to potential skin irritation and increase in stress around the ankle joint.
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The influence of passive-dynamic ankle-foot orthosis bending axis location on gait performance in individuals with lower-limb impairments.

TL;DR: In this study, altering bending axis location did not produce large and consistent changes in gait performance, suggesting individual preference and comfort may be more important factors guiding prescription.
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Design of a 2dof ankle exoskeleton with a polycentric structure and a bi-directional tendon-driven actuator controlled using a pid neural network

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References
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Journal Article

Anthropometric studies of the human foot and ankle

TL;DR: A study of the talocrural (ankle) and talocalcaneal (subtalar) joints was made in order to acquire as much information as possible on the exact locations of their axes of rotation.
Journal ArticleDOI

The axis of rotation of the ankle joint

TL;DR: The study indicates that the talo-crural joint axis may alter considerably during the arc of motion and differ significantly between individuals, which prompts caution in the use of hinge axes in orthoses and prostheses for the ankle.
Journal ArticleDOI

In vivo determination of the anatomical axes of the ankle joint complex: An optimization approach

TL;DR: It is concluded that this optimization method provides the opportunity to incorporate inter-individual anatomical differences into kinematic and dynamic analysis of the ankle joint complex, and allows a more functional interpretation of kinematics data, and more realistic estimates of internal forces.
Journal ArticleDOI

Biomechanics of the ankle: a kinematic study.

TL;DR: In this paper, the authors examined twenty-six normal ankles to determine the tibiotalar range of motion during dorsiflexion and plantar flexion during weight bearing and non-weight bearing.
Journal ArticleDOI

Articulated external fixation of the ankle: minimizing motion resistance by accurate axis alignment

TL;DR: While articulated external fixation with limited internal fixation can establish a favorable environment for the repair of severe injuries such as tibial pilon fractures, the large additional resistance to motion accompanying a malpositioned fixator axis suggests the development of untoward intra-articular forces that could act to disturb fragment alignment.
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