Improving mobility in peripheral artery disease using an ankle foot orthosis

使用踝足矫形器改善外周动脉疾病的活动能力

基本信息

批准号：
9515569
负责人：
Sara A Myers
金额：
$ 41.56万
依托单位：
UNIVERSITY OF NEBRASKA OMAHA
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-23 至 2021-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9515569
关键词：
Address Affect Age-Years American Ankle Arteries Atherosclerosis Biomechanics Blood flow Carbon Cardiovascular Diseases Characteristics Crossover Design Devices Disease Ensure Exercise Failure Foot-drop Functional disorder Gait Gastrocnemius Muscle Health Individual Intermittent Claudication Intervention Ischemia Kinetics Laboratories Leg Limb structure Long-Term Effects Measurement Measures Motivation Muscle Muscle Cramp Muscle function Myalgia Myopathy Neuromuscular Diseases Orthotic Devices Outcome Oxygen Pain Pain in lower limb Participant Patients Performance Peripheral arterial disease Pharmacotherapy Physical Function Physical activity Property Quality of life Reporting Research Resources Rest Stress Stroke Supervision Symptoms Target Populations Testing Time Toes Torque Walking Weight Work claudication cost effective therapy experience fall risk foot functional status hemodynamics improved improved functioning improved mobility mechanical force muscle strength novel strategies prevent satisfaction sedentary success treadmill treatment planning

项目摘要

Peripheral artery disease (PAD) is a manifestation of systemic atherosclerosis, characterized by atherosclerotic blockages of the arteries supplying the legs. Claudication, defined as walking induced gait dysfunction and muscle pain, is the most common manifestation of PAD. Claudication affects 5% of Americans older than 55 years of age. Claudicating patients experience reduced mobility, reduced physical functioning, poor health outcomes, and increased risk for falls. Research in our laboratory has documented significant deficits in the ankle plantarflexors to generate normal torque and power during walking. Further, affected legs of patients with PAD demonstrate a muscle myopathy that prevents normal muscle function. While supervised exercise is effective for increasing the distance patients with PAD can walk, it does not generate ankle plantarflexor torque, or decrease stress on the leg muscles. An ankle- foot orthosis (AFO) is a device made of carbon-composite material that can offset ankle plantarflexor torque and power and decrease blood flow demand and muscular stress during walking. The spring-like properties of carbon composite AFOs allow energy storage at weight acceptance and return at the point of toe off. Our pilot work has shown that walking with an AFO immediately increases the initial and absolute walking distances in patients with PAD as much as pharmacotherapy for six months. This study will determine whether an AFO improves walking performance in patients with PAD from its first use. Additionally, the study will test walking performance after a three month AFO intervention and will examine the feasibility of this AFO intervention. The central hypothesis is that the AFO immediately improves walking performance by decreasing the energy cost of walking. Walking performance improvement following the three-month intervention is expected to be larger than that of first use due to improving the muscular function of patients' affected legs. Detailed measures of mechanisms related with walking performance, muscle contribution, physical activity, quality of life and how these mechanisms change after wearing the AFO for three months will provide the evidence required to implement an AFO therapy that will improve functional status and quality of life in individuals with PAD.

外周动脉疾病（PAD）是全身动脉粥样硬化的一种表现，其特征是供应腿部的动脉发生粥样硬化阻塞。跛行定义为行走引起的步态功能障碍和肌肉疼痛，是最常见的 PAD 的常见表现。 5% 55 岁以上的美国人患有跛行岁数。跛行患者活动能力下降，体力下降功能障碍、健康状况不佳以及跌倒风险增加。我们的研究实验室已经记录了踝关节跖屈肌的显着缺陷，以产生行走时的正常扭矩和功率。此外，PAD 患者受影响的腿部证明肌肉肌病会妨碍正常的肌肉功能。在监督的同时运动对于增加 PAD 患者的步行距离有效，但并不能产生踝关节跖屈肌扭矩，或减少腿部肌肉的压力。一个脚踝—— 足矫形器（AFO）是一种由碳复合材料制成的可以偏移踝关节的装置跖屈肌扭矩和功率，减少血流需求和肌肉压力步行期间。碳复合材料 AFO 具有类似弹簧的特性，可提供能量在重量接受时存储并在脚趾离地时返回。我们的试点工作表明佩戴 AFO 行走会立即增加初始行走和绝对行走 PAD 患者的距离与药物治疗六个月一样多。这项研究将确定 AFO 是否可以改善 PAD 患者的步行能力它的第一次使用。此外，该研究还将测试三个月 AFO 后的步行表现干预并将研究 AFO 干预的可行性。中央假设 AFO 通过减少步行的能量消耗。三个月后步行表现有所改善由于改善了肌肉，预计干预效果将比首次使用时更大。患者受影响腿部的功能。相关机制的具体措施步行表现、肌肉贡献、体力活动、生活质量以及这些佩戴AFO三个月后机制的变化将提供证据需要实施 AFO 疗法，以改善功能状态和质量 PAD 患者的生活。