Gait in Controlled Ankle Movement (CAM) Walker Boot Using a Contralateral Shoe Lift

Category: Basic Sciences/Biologics; Other Introduction/Purpose: Walking mechanics play a fundamental role in daily mobility and are significantly influenced by footwear choices, particularly in individuals with lower limb conditions. Among the interventions commonly used in rehabilitation settings a...

Full description

Saved in:
Bibliographic Details
Main Authors: Dino Fanfan BSc, Sergio Lemus Orellana, Kyra E. Lopez MSc, Francesco Travascio PhD, Daniel Murray MD, Cary B. Chapman MD
Format: Article
Language:English
Published: SAGE Publishing 2024-12-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/2473011424S00302
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846109672042397696
author Dino Fanfan BSc
Sergio Lemus Orellana
Kyra E. Lopez MSc
Francesco Travascio PhD
Daniel Murray MD
Cary B. Chapman MD
author_facet Dino Fanfan BSc
Sergio Lemus Orellana
Kyra E. Lopez MSc
Francesco Travascio PhD
Daniel Murray MD
Cary B. Chapman MD
author_sort Dino Fanfan BSc
collection DOAJ
description Category: Basic Sciences/Biologics; Other Introduction/Purpose: Walking mechanics play a fundamental role in daily mobility and are significantly influenced by footwear choices, particularly in individuals with lower limb conditions. Among the interventions commonly used in rehabilitation settings are controlled ankle movement (CAM) boots and shoe lifts, which aim to provide support and improve gait dynamics. The purpose of this outcome study was to test how different a person walks when wearing the controlled ankle movement (CAM) boot and the shoe lift compared to walking with your running shoes. Methods: We conducted a prospective cohort study comprised of 30 participants, 15 men and women, who underwent three-level walking trials under the following conditions: athletic shoes, tall CAM boot, and tall CAM boot with a balancer added to the contralateral foot. Sixteen anatomical markers were placed on participants according to Vicon’s Plug-in Gait Full Body (PIGFB) model. Kinematic data and ground reaction forces were collected at 500 Hz and processed with the PIGFB biomechanical model and Vicon’s gait cycle parameters. Data post-processing provided spatiotemporal gait parameters (contact times, stride length, speed, time spent in stance/swing phases, cadence) and lower limb kinematics and kinetics (knee and hip joint angles, movement, and forces). A Two-Way ANOVA, using walking condition and gender as factors, followed by a Tukey Pairwise comparison identified significant effects of walking conditions on various gait characteristics. Results: In both limbs, cadence (p = 0.002) and step width (p < 0.001) were significantly different in NB compared to CAM and CAMB. Specific to contralateral limb, stride time (p = 0.025), step time (p = 0.007), and limb index (p ≤ 0.001) were also affected. Regarding kinematics, the walking condition significantly affected contralateral hip abduction angle (p = 0.027). In addition, the walking condition had significant effect on the ipsilateral limb for both knee internal rotation (p = 0.024), and knee varus/adduction angle (p = 0.024). Regarding kinetics, the walking condition affected hip medial/lateral force (p =0.002), knee compression force (p =0.029), and knee varus/adduction moment (p = 0.024). The boot condition had the greatest hip force (5.7 N/kg) compared with the NB and CAMB conditions. Conclusion: Our study demonstrates significant changes in gait patterns and lower limb biomechanics when individuals wear a controlled ankle movement (CAM) boot and a shoe lift compared to athletic shoes. These results underscore the importance of considering footwear interventions in clinical and rehabilitation settings, as they can substantially influence gait patterns and biomechanical dynamics, highlighting the need for careful consideration in clinical and rehabilitation settings.
format Article
id doaj-art-b8e88ca699bf4b838618d66817016e03
institution Kabale University
issn 2473-0114
language English
publishDate 2024-12-01
publisher SAGE Publishing
record_format Article
series Foot & Ankle Orthopaedics
spelling doaj-art-b8e88ca699bf4b838618d66817016e032024-12-25T08:03:35ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142024-12-01910.1177/2473011424S00302Gait in Controlled Ankle Movement (CAM) Walker Boot Using a Contralateral Shoe LiftDino Fanfan BScSergio Lemus OrellanaKyra E. Lopez MScFrancesco Travascio PhDDaniel Murray MDCary B. Chapman MDCategory: Basic Sciences/Biologics; Other Introduction/Purpose: Walking mechanics play a fundamental role in daily mobility and are significantly influenced by footwear choices, particularly in individuals with lower limb conditions. Among the interventions commonly used in rehabilitation settings are controlled ankle movement (CAM) boots and shoe lifts, which aim to provide support and improve gait dynamics. The purpose of this outcome study was to test how different a person walks when wearing the controlled ankle movement (CAM) boot and the shoe lift compared to walking with your running shoes. Methods: We conducted a prospective cohort study comprised of 30 participants, 15 men and women, who underwent three-level walking trials under the following conditions: athletic shoes, tall CAM boot, and tall CAM boot with a balancer added to the contralateral foot. Sixteen anatomical markers were placed on participants according to Vicon’s Plug-in Gait Full Body (PIGFB) model. Kinematic data and ground reaction forces were collected at 500 Hz and processed with the PIGFB biomechanical model and Vicon’s gait cycle parameters. Data post-processing provided spatiotemporal gait parameters (contact times, stride length, speed, time spent in stance/swing phases, cadence) and lower limb kinematics and kinetics (knee and hip joint angles, movement, and forces). A Two-Way ANOVA, using walking condition and gender as factors, followed by a Tukey Pairwise comparison identified significant effects of walking conditions on various gait characteristics. Results: In both limbs, cadence (p = 0.002) and step width (p < 0.001) were significantly different in NB compared to CAM and CAMB. Specific to contralateral limb, stride time (p = 0.025), step time (p = 0.007), and limb index (p ≤ 0.001) were also affected. Regarding kinematics, the walking condition significantly affected contralateral hip abduction angle (p = 0.027). In addition, the walking condition had significant effect on the ipsilateral limb for both knee internal rotation (p = 0.024), and knee varus/adduction angle (p = 0.024). Regarding kinetics, the walking condition affected hip medial/lateral force (p =0.002), knee compression force (p =0.029), and knee varus/adduction moment (p = 0.024). The boot condition had the greatest hip force (5.7 N/kg) compared with the NB and CAMB conditions. Conclusion: Our study demonstrates significant changes in gait patterns and lower limb biomechanics when individuals wear a controlled ankle movement (CAM) boot and a shoe lift compared to athletic shoes. These results underscore the importance of considering footwear interventions in clinical and rehabilitation settings, as they can substantially influence gait patterns and biomechanical dynamics, highlighting the need for careful consideration in clinical and rehabilitation settings.https://doi.org/10.1177/2473011424S00302
spellingShingle Dino Fanfan BSc
Sergio Lemus Orellana
Kyra E. Lopez MSc
Francesco Travascio PhD
Daniel Murray MD
Cary B. Chapman MD
Gait in Controlled Ankle Movement (CAM) Walker Boot Using a Contralateral Shoe Lift
Foot & Ankle Orthopaedics
title Gait in Controlled Ankle Movement (CAM) Walker Boot Using a Contralateral Shoe Lift
title_full Gait in Controlled Ankle Movement (CAM) Walker Boot Using a Contralateral Shoe Lift
title_fullStr Gait in Controlled Ankle Movement (CAM) Walker Boot Using a Contralateral Shoe Lift
title_full_unstemmed Gait in Controlled Ankle Movement (CAM) Walker Boot Using a Contralateral Shoe Lift
title_short Gait in Controlled Ankle Movement (CAM) Walker Boot Using a Contralateral Shoe Lift
title_sort gait in controlled ankle movement cam walker boot using a contralateral shoe lift
url https://doi.org/10.1177/2473011424S00302
work_keys_str_mv AT dinofanfanbsc gaitincontrolledanklemovementcamwalkerbootusingacontralateralshoelift
AT sergiolemusorellana gaitincontrolledanklemovementcamwalkerbootusingacontralateralshoelift
AT kyraelopezmsc gaitincontrolledanklemovementcamwalkerbootusingacontralateralshoelift
AT francescotravasciophd gaitincontrolledanklemovementcamwalkerbootusingacontralateralshoelift
AT danielmurraymd gaitincontrolledanklemovementcamwalkerbootusingacontralateralshoelift
AT carybchapmanmd gaitincontrolledanklemovementcamwalkerbootusingacontralateralshoelift