Biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosis
Abstract Background Gait impairment is a common complication of multiple sclerosis (MS). Gait limitations such as limited hip flexion, foot drop, and knee hyperextension often require external devices like crutches, canes, and orthoses. The effects of mobility-assistive technologies (MATs) prescribe...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-06-01
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| Series: | Journal of NeuroEngineering and Rehabilitation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12984-021-00891-7 |
| _version_ | 1819146139622965248 |
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| author | Ross M. Neuman Staci M. Shearin Karen J. McCain Nicholas P. Fey |
| author_facet | Ross M. Neuman Staci M. Shearin Karen J. McCain Nicholas P. Fey |
| author_sort | Ross M. Neuman |
| collection | DOAJ |
| description | Abstract Background Gait impairment is a common complication of multiple sclerosis (MS). Gait limitations such as limited hip flexion, foot drop, and knee hyperextension often require external devices like crutches, canes, and orthoses. The effects of mobility-assistive technologies (MATs) prescribed to people with MS are not well understood, and current devices do not cater to the specific needs of these individuals. To address this, a passive unilateral hip flexion-assisting orthosis (HFO) was developed that uses resistance bands spanning the hip joint to redirect energy in the gait cycle. The purpose of this study was to investigate the short-term effects of the HFO on gait mechanics and muscle activation for people with and without MS. We hypothesized that (1) hip flexion would increase in the limb wearing the device, and (2) that muscle activity would increase in hip extensors, and decrease in hip flexors and plantar flexors. Methods Five healthy subjects and five subjects with MS walked for minute-long sessions with the device using three different levels of band stiffness. We analyzed peak hip flexion and extension angles, lower limb joint work, and muscle activity in eight muscles on the lower limbs and trunk. Single-subjects analysis was used due to inter-subject variability. Results For subjects with MS, the HFO caused an increase in peak hip flexion angle and a decrease in peak hip extension angle, confirming our first hypothesis. Healthy subjects showed less pronounced kinematic changes when using the device. Power generated at the hip was increased in most subjects while using the HFO. The second hypothesis was not confirmed, as muscle activity showed inconsistent results, however several subjects demonstrated increased hip extensor and trunk muscle activity with the HFO. Conclusions This exploratory study showed that the HFO was well-tolerated by healthy subjects and subjects with MS, and that it promoted more normative kinematics at the hip for those with MS. Future studies with longer exposure to the HFO and personalized assistance parameters are needed to understand the efficacy of the HFO for mobility assistance and rehabilitation for people with MS. |
| first_indexed | 2024-12-22T13:09:11Z |
| format | Article |
| id | doaj.art-f304392653384e9599961925efa61bdc |
| institution | Directory Open Access Journal |
| issn | 1743-0003 |
| language | English |
| last_indexed | 2024-12-22T13:09:11Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj.art-f304392653384e9599961925efa61bdc2022-12-21T18:24:47ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032021-06-0118111310.1186/s12984-021-00891-7Biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosisRoss M. Neuman0Staci M. Shearin1Karen J. McCain2Nicholas P. Fey3Walker Department of Mechanical Engineering, The University of Texas at AustinUT Southwestern Medical CenterUT Southwestern Medical CenterWalker Department of Mechanical Engineering, The University of Texas at AustinAbstract Background Gait impairment is a common complication of multiple sclerosis (MS). Gait limitations such as limited hip flexion, foot drop, and knee hyperextension often require external devices like crutches, canes, and orthoses. The effects of mobility-assistive technologies (MATs) prescribed to people with MS are not well understood, and current devices do not cater to the specific needs of these individuals. To address this, a passive unilateral hip flexion-assisting orthosis (HFO) was developed that uses resistance bands spanning the hip joint to redirect energy in the gait cycle. The purpose of this study was to investigate the short-term effects of the HFO on gait mechanics and muscle activation for people with and without MS. We hypothesized that (1) hip flexion would increase in the limb wearing the device, and (2) that muscle activity would increase in hip extensors, and decrease in hip flexors and plantar flexors. Methods Five healthy subjects and five subjects with MS walked for minute-long sessions with the device using three different levels of band stiffness. We analyzed peak hip flexion and extension angles, lower limb joint work, and muscle activity in eight muscles on the lower limbs and trunk. Single-subjects analysis was used due to inter-subject variability. Results For subjects with MS, the HFO caused an increase in peak hip flexion angle and a decrease in peak hip extension angle, confirming our first hypothesis. Healthy subjects showed less pronounced kinematic changes when using the device. Power generated at the hip was increased in most subjects while using the HFO. The second hypothesis was not confirmed, as muscle activity showed inconsistent results, however several subjects demonstrated increased hip extensor and trunk muscle activity with the HFO. Conclusions This exploratory study showed that the HFO was well-tolerated by healthy subjects and subjects with MS, and that it promoted more normative kinematics at the hip for those with MS. Future studies with longer exposure to the HFO and personalized assistance parameters are needed to understand the efficacy of the HFO for mobility assistance and rehabilitation for people with MS.https://doi.org/10.1186/s12984-021-00891-7BiomechanicsMultiple sclerosisHip flexion orthosis |
| spellingShingle | Ross M. Neuman Staci M. Shearin Karen J. McCain Nicholas P. Fey Biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosis Journal of NeuroEngineering and Rehabilitation Biomechanics Multiple sclerosis Hip flexion orthosis |
| title | Biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosis |
| title_full | Biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosis |
| title_fullStr | Biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosis |
| title_full_unstemmed | Biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosis |
| title_short | Biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosis |
| title_sort | biomechanical analysis of an unpowered hip flexion orthosis on individuals with and without multiple sclerosis |
| topic | Biomechanics Multiple sclerosis Hip flexion orthosis |
| url | https://doi.org/10.1186/s12984-021-00891-7 |
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