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

• 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
• 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

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.

周围动脉疾病（PAD）是全身性动脉粥样硬化的表现， 其特征是动脉的动脉粥样硬化堵塞腿部。 被定义为步行诱导的步态功能障碍和肌肉疼痛的lau亵是最大的 垫的常见表现。 lau不休影响55岁以上的美国人的5％ 年龄。克劳德患者的流动性降低，身体降低 功能，健康状况不佳以及跌倒风险增加。我们的研究 实验室已经记录了脚踝plantlexors中的严重缺陷以产生 步行过程中的正常扭矩和动力。此外，患者的腿部受影响 证明肌肉肌病可防止正常的肌肉功能。在监督的情况下 运动可有效增加垫子的距离患者可以行走，而不是 产生脚踝plant骨扭矩，或减轻腿部肌肉的压力。脚踝 - 脚矫形器（AFO）是一种由碳复合材料制成的装置，可以抵消脚踝 足底反射器扭矩和功率，减少血流需求和肌肉应力 在步行期间。碳复合材料AFO的春季样特性允许能量 重量接受存储并在脚趾关闭时返回。我们的飞行员工作已经表明 与AFO一起行走的立即增加了最初和绝对的步行 PAD患者与药物治疗的距离六个月。这项研究 将确定AFO是否改善了PAD患者的步行性能 它的第一个用途。此外，该研究将在三个月后测试步行性能 干预并将检查此AFO干预的可行性。中央 假设是AFO立即通过减少来提高步行性能 步行的能源成本。三个月后步行绩效改善 由于改善肌肉，预计干预措施将大于首次使用的干预措施 患者受影响的腿的功能。与 步行表现，肌肉贡献，体育锻炼，生活质量以及如何 佩戴AFO后三个月后的机制将提供证据 需要实施AFO疗法，以提高功能状态和质量 带有垫子的人的生活。