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Objective Stroke occurs when the supply of blood to the brain is either interrupted or reduced. The clinical presentation varies from minor neurological symptoms to severe deficits, depending on the location and the size of the brain lesion. Hemiparesis is one of the most striking features in the acute phase. Many other deficits may also be present, including postural imbalance. All persistent neurological deficits may cause more or less severe activity limitations in several domains of human functioning. Regaining walking ability is a major goal during the rehabilitation of stroke patients. Therefore, using orthoses can be beneficial for them. Ankle-Foot Orthoses (AFOs) is one of the most common therapeutic approaches to control foot drop among stroke patients. AFOs prevent drooping or other unintended movements of the foot and ankle by providing stability in optimum conditions. It also helps in regaining normal walking posture in stroke patients. The aim of this review was to evaluate the efficiency of the AFOs on balance and examine the effectiveness of temporal spatial and kinetic gait kinematics in stroke patients with foot drop.
Materials & Methods Science Direct, Springer, Google Scholar, PubMed, Ovid databases were searched for articles published between 1996 and 2016 of studies on patients with drop foot wearing the AFOs. After reviewing and categorizing the articles, they were analyzed based on spatiotemporal parameters, gait kinetics, gait kinematics and stability. A total of 21 articles were selected for final evaluation.
Results Twenty-one articles were analyzed in relation to the effect of the AFOs on gait parameters in stroke patients. Spatiotemporal parameters were evaluated in 14 articles, and kinetics and kinematics parameters were analyzed in seven articles. AFOs have a significant impact on the length and width of the steps but had no significant effect on speed, cadence, symmetry of gait and balance. Also, AFOs improved kinetic parameters of gait, ankle kinematics and kinematics of the knee in the static phase but had no significant effect on knee joint kinematics and kinematics of the hip joint in the frontal and sagittal. There are a few studies with regard to the effects of AFOs on the moment of inertia and joints power, but the results of the present study showed no significant difference in these parameters.
Conclusion This study showed that the AFOs based on the models (static or dynamic) had a paradoxical effect on balance, kinetic and kinematic parameters of gait in the stroke patients. AFOs had a significant improvement in balance, kinetic and kinematic parameters of gait compared to those without orthosis situation in the stroke patients. According to the result of this study, depending on the patient's needs and situation, the best and the most suitable ankle foot orthoses should be designed and custom molded for them.

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Objective Knee osteoarthritis is a common, progressive, and chronic disease that affects approximately 13% of the population over the age of 60. Osteoarthritis causes progressive disability and changes in gait parameters, decreased function and quality of life of patients by causing malalignment of the knee in the frontal plane following destruction of articular cartilage. Braces as a mechanical intervention are a successful treatment for osteoarthritis knee and its associated malalignment. Using a three-point pressure mechanism, braces create a natural alignment in the knee by straps attached to the thigh and shank shells, which reduce the medial knee load and correct the varus alignment. This distributes the force properly while walking. However, applying a constant force on three pressure points of the leg, thigh and affected knee joint reduces the adduction angle of the knee in all phases of gait cycle , while the correction of the adduction angle of the knee in patients is essential only in phases between 30% to 60% of the stance phase, when the knee deviation reaches its peak. The aim of this study is to design and fabricate a brace joint with a new intermittent correction mechanism for patients with osteoarthritis medial compartment knee and to investigate its effect on a patient's gait parameters.
Materials & Methods The new joint design of the knee brace was based on the conversion of the knee extension movement at the end of the swing on the sagittal plane to the abduction movement on the frontal plate by stretching the converter piece. Participant gait was assessed in two ways with and without braces. Kinematic variables including knee joint angles in the sagittal and frontal planes and spatio-temporal variables of patient gait were measured and recorded.
Results The results of the new brace joint function on the knee showed that the angle of flexion of the knee in the swing phase increased from 44.72° to 46.19° when using brace. Also, knee adduction angle in the stance phase decreased from 4.25° to 2.3° and patient's walking speed while wearing the brace increased from 0.88 m/s to 0.93 m/s. On the other hand, step length increased from 1.125 m to 1.451 m when using brace and the percentage of stance phase decreased from 63.53 to 62.68 when using brace.
Conclusion In this one-sample study, a knee brace with a new joint was able to help correct the direction of knee joint in the frontal and sagittal plane and affect the patient's gait parameters. It seems that if the same results are obtained in a large-scale clinical study, this brace could be a suitable replacement for invasive methods and inappropriate orthoses.