Six-minute walk performance in persons with multiple sclerosis while using passive or powered ankle-foot orthoses

Publication date: Available online 2 August 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Morgan K. Boes, Rachel E. Bollaert, Richard Kesler, Yvonne C. Learmonth, Mazharul Islam, Matthew N. Petrucci, Robert W. Motl, Elizabeth T. Hsiao-Wecksler
ObjectiveTo determine if a powered ankle-foot orthosis that provides dorsiflexor and plantarflexor assistance at the ankle can improve walking endurance of persons with multiple sclerosis (MS)DesignShort-term interventionSettingUniversity research laboratoryParticipantsSixteen participants with a neurologist-confirmed diagnosis of MS and daily use of a prescribed custom unilateral passive ankle-foot orthosis (AFO). Participants were persons with moderate to severe neurological disability.InterventionsThree 6-minute walk tests (6MW), one per footwear condition: shoes (no AFO), prescribed passive AFO, and powered portable AFO (PPAFO). Assistive devices were worn on the impaired limb.Main Outcome MeasuresDistance walked and metabolic cost of transport were collected during each 6MW and compared between footwear conditions.ResultsEach participant completed all three 6MW tests within the experimental design. PPAFO use resulted in a shorter 6MW distance than a passive AFO or shoes. There were no differences in metabolic cost of transport based on footwear.ConclusionsThe current embodiment of this portable powered AFO did not improve endurance walking performance based on 6MW in a sampling of participants with gait impairment due to MS. Further research is required to determine if expanded training or modified design of this powered orthosis can be effective at improving endurance walking performance in persons with gait impairment due to MS.



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