Patients suffering from medial compartment knee osteoarthritis (OA) may be treated with unloader knee orthoses or laterally wedged insoles. The aim of this study was to identify and compare the effects of them on the gait parameters and pain in these patients. Quasi-experimental. Volunteer subjects with medial compartment knee OA (n = 24, mean age 59.29 ± 2.23 years) were randomly assigned to two separate groups and evaluated when wearing an unloader knee orthosis or insoles incorporating a 6° lateral wedge. Testing was performed at baseline and after six weeks of each orthosis use. A visual analog scale score was used to assess pain and gait analysis was utilized to determine gait parameters. Both orthoses improved all parameters compared to the baseline condition (p = 0.000). However, no significant differences in pain (p = 0.649), adduction moment (p = 0.205), speed of walking (p = 0. 056) or step length (p = 0.687) were demonstrated between them. The knee range of motion (p = 0.000) were significantly different between the two interventions. Both orthoses reduced knee pain. Maximum knee range of motion was increased by both interventions although it was 3 degrees less when wearing the knee orthosis. Both orthoses reduce pain and improve gait anomalies in medial compartment knee OA. Our results suggest a laterally wedged insole can be an alternative conservative approach to unloader knee orthosis for treating symptoms of medial compartment knee OA.

Ankle characteristics vary in terms of gait phase and speed change. This study aimed to quantify the components of ankle characteristics, including quasi-stiffness and work in different gait phases and at various speeds. The kinetic and kinematic data of 20 healthy participants were collected during normal gait at four speeds. Stance moment-angle curves were divided into three sub-phases including controlled plantarflexion, controlled dorsiflexion and powered plantarflexion. The slope of the moment-angle curves was quantified as quasi-stiffness. The area under the curves was defined as work. The lowest quasi-stiffness was observed in the controlled plantarflexion. The fitted line to moment-angle curves showed R² > 0.8 at controlled dorsiflexion and powered plantarflexion. Quasi-stiffness was significantly different at different speeds (P = 0.00). In the controlled dorsiflexion, the ankle absorbed energy; by comparison, energy was generated in the powered plantarflexion. A negative work value was recorded at slower speeds and a positive value was observed at faster speeds. Ankle peak powers were increased with walking speed (P = 0.00). Our findings suggested that the quasi-stiffness and work of the ankle joint can be regulated at different phases and speeds. These findings may be clinically applicable in the design and development of ankle prosthetic devices that can naturally replicate human walking at various gait speeds.

This study is aimed at comparing muscle activations and synergies in badminton forehand overhead smash (BFOS) between elite and nonelite players to clarify how the central nervous system (CNS) controls neuromuscular synergy and activation to generate complex overhead movements. EMG of five upper limb muscles was recorded through surface electromyography (EMG) electrodes from twenty players. Athletics is divided into two groups: elite and nonelite. Eventually, nonnegative matrix factorization (NNMF) was utilized to the calculated electromyography signals for muscle synergy comparison. Similarities between elite and nonelite groups were calculated by scalar product method. Results presented that three muscles synergies could sufficiently delineate the found electromyography signals for elite and nonelite players. Individual muscle patterns were moderately to highly similar between elite and nonelite groups (between-group similarity range: 0.52 to 0.90). In addition, high similarities between groups were found for the shape of synergy activation coefficients (range: 0.85 to 0.89). These results indicate that the synergistic organization of muscle coordination during badminton forehand overhead smash is not profoundly affected by expertise.

Background and Aim: This article describes the development and testing of a new powered gait orthosis to potentially assist spinal cord injury patients to walk by producing synchronized hip and knee joint movements. Technique: The first evaluation of the orthosis was performed without users, and was followed by evaluation of the orthosis performance using three healthy subjects to test the structure under weight-bearing conditions. The orthosis was primarily evaluated to ascertain its ability to generate appropriate hip and knee motion during walking. The walking experiments replicated the flexion and extension of both the hip and knee produced by the actuators which had previously been demonstrated during the initial computer simulations. Discussion: The results suggest that this new orthosis could be used to assist paraplegic subjects who have adequate ranges of motion and also with weakness or reduced tone to ambulate, and may also be suitable for other subjects with impaired lower limb function (e.g. stroke, poliomyelitis, myelomeningocele and traumatic brain injury provided they do not have increased tone or movement disorders. Clinical relevance The new powered gait orthosis can provide walking assistance for patients with a spinal cord injury who have a good range of motion at the hip and knee and who also have weakness or reduced tone.

The aim of this case study was to identify the effect of a powered stance control knee ankle foot orthosis on the kinematics and temporospatial parameters of walking by a person with poliomyelitis when compared to a knee ankle foot orthosis. A knee ankle foot orthosis was initially manufactured by incorporating drop lock knee joints and custom molded ankle foot orthoses and fitted to a person with poliomyelitis. The orthosis was then adapted by adding electrically activated powered knee joints to provide knee extension torque during stance and also flexion torque in swing phase. Lower limb kinematic and kinetic data plus data for temporospatial parameters were acquired from three test walks using each orthosis. Walking speed, step length, and vertical and horizontal displacement of the pelvis decreased when walking with the powered stance control knee ankle foot orthosis compared to the knee ankle foot orthosis. When using the powered stance control knee ankle foot orthosis, the knee flexion achieved during swing and also the overall pattern of walking more closely matched that of normal human walking. The reduced walking speed may have caused the smaller compensatory motions detected when the powered stance control knee ankle foot orthosis was used. The new powered SCKAFO facilitated controlled knee flexion and extension during ambulation for a volunteer poliomyelitis person. The powered stance control knee ankle foot orthosis has the potential to improve knee joint kinematics in persons with poliomyelitis when ambulating.

Background: The aim of this case study was to analyze the effect on gait parameters of a new design of powered gait orthosis which applied synchronized motions to both the hip and knee joints when utilized for walking by a spinal cord injury (SCI) patient. Case Description and Methods: Two orthoses were evaluated while worn by an incomplete SCI subject. Gait evaluation was performed when walking with an isocentric reciprocating gait orthosis (IRGO) and compared to that demonstrated by a newly developed powered version. This new orthosis was based on the IRGO superstructure but incorporated powered hip and knee joints using electrically motorized actuators. Findings and Outcomes: These gait parameters were improved when compared to standard IRGO and initial testing with the orthosis with only the hip or the knee joints activated in isolation. Maximum hip flexion and extension angles, as well as the maximum knee flexion and extension angles all increased when walking with the powered RGO compared to the IRGO. Conclusions: Gait evaluation of this newly developed orthosis showed improvement in measured parameters when compared to walking with an IRGO. Clinical relevance This case study gave the authors confidence to extend the research to a more extensive study with a group of SCI patients.