October 2011

Increases in gait speed with brace use vary in Charcot-Marie-Tooth patients

In the moment: O&P

Patients with Charcot-Marie-Tooth (CMT) disease respond to the same custom ankle foot orthosis (AFO) in very different ways, according to research from the University of Nevada, Las Vegas presented in September at the annual AOPA meeting.

Investigators assessed eight CMT patients wearing a custom AFO made of multiple layers of bidirectional carbon and Kevlar, with a rigid heel and forefoot and struts to allow the patient to lean into the brace. All patients had worn the AFO for at least 10 weeks.

Some patients walked up to 60% faster with the brace than without, but some patients experienced no change in gait speed. Those with no speed change were strongest and more likely to experience joint moment changes at the hip with the brace than without; those whose speed increased had greater changes in knee joint moment, increased power at the knee, and decreased power at the hip while braced.

Of three patients who wore instrumented braces, one was from the subgroup that demonstrated the greatest change in speed while the other two patients demonstrated minimal increases. Speed increase was associated with higher levels of device stiffness, energy storage, and energy release.

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