The impact of combined use of ankle-foot orthosis and the Reverse Omega Shoe Insert (ROSI) on the gait of individuals with spinal paralysis

Abstract

This study examined the effects of using ankle-foot orthoses (AFOs) on individuals with spinal cord paralysis. In addition, we evaluated the combined effects of using the Reverse Omega Shoe Insert (ROSI). Five male participants with spinal cord paralysis (average age 54.2±21.4 years) were gait analyzed under four conditions: barefoot, with a dorsiflexion-assist AFO, with a dorsiflexion-stop AFO, and with a dorsiflexion-stop AFO combined with ROSI. A three-dimensional motion analysis system was used for measurements. Time-distance factors and kinematic parameters of gait were calculated, and the standardized data were analyzed using the Steel-Dwass method. It was found that the level of hip extensor muscle weakness influenced the selection of AFO in terms of increasing ankle plantarflexion moment with AFO use. Moreover, combining ROSI with a dorsiflexion-stop AFO contributed to improved propulsion and increased anterior displacement of the center of pressure, resulting in an increased step length.