PubMed · 4558071
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H R Lehneis. 1972. New developments in lower-limb orthotics through bioengineering.. https://pubmed.ncbi.nlm.nih.gov/4558071/
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We compared the electromyographic (EMG) signals of lower extremity muscle groups in 10 children with hemiplegic cerebral palsy (CP) while walking barefoot and in a hinged ankle-foot orthosis (HAFO). All children had excessive plantarflexion and initial toe-contact on the affected side when walking barefoot, a typical gait pattern for hemiplegic patients. The patients walked with a physiological heel-toe gait pattern when wearing the HAFO. The peak activity of the tibialis anterior muscle was reduced by 36.1% at initial contact and loading response phase and by 57.3% just after toe-off when using a HAFO. The decrease in activity was thought to result from the change in gait pattern from a toe-gait to a heel-toe gait as well as the use of a HAFO. The HAFO also slightly decreased muscle activity in the proximal leg muscles mainly during swing phase, improved stride length, decreased cadence, improved walking speed, increased peak hip flexion, improved kinematics in loading response phase at the knee, and reduced the excessive ankle plantarflexion.
The incidence of osteoarthritis is significantly higher in the knee as compared to the ankle, suggesting that differences in the properties of cartilage from these joints may contribute to the development of osteoarthritis. As an avascular tissue, articular cartilage depends primarily upon diffusion for molecular transport. The goal of this study was to determine if differences in the structure and composition between ankle and knee cartilage were also reflected as differences in solute transport properties. The diffusion coefficient and partition coefficient of a 70-kDa dextran molecule were measured in human ankle and knee articular cartilage using fluorescence recovery after photobleaching (FRAP) and were compared to the proteoglycan, collagen, water, and DNA contents within each zone. The mean partition coefficient was significantly lower in the ankle compared to the knee (0.010+/-0.002 vs. 0.022+/-0.003, p<0.01), but no differences in the diffusion coefficients were observed (34.6 +/- 0.9 microm(2)s(-1) vs. 35.4+/-2.4 microm(2)s(-1), p=0.70). Ankle cartilage exhibited higher proteoglycan content as well as a trend toward lower water content, suggesting that ankle cartilage has a smaller effective pore size than knee cartilage. These findings suggest that differences in the composition of ankle and knee cartilage contribute to a difference in the partition coefficient. The results of this study provide further support for the hypothesis that the transport properties of cartilage may play a role in the differences in the incidence of osteoarthritis in these joints by altering the effective concentration of growth factors and cytokines to which chondrocytes are exposed.