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Optimizing ankle foot orthosis stiffness in calf muscle weakness

Waterval, N.F.J.

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Citation for published version (APA):Waterval, N. F. J. (2020). Optimizing ankle foot orthosis stiffness in calf muscle weakness.

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Download date: 18 Dec 2020

OPTIMIZING ANKLE FOOT ORTHOSIS STIFFNESS

IN CALF MUSCLE WEAKNESS

NIELS WATERVAL

OPTIM

IZING

AN

KLE FO

OT O

RTHO

SIS STIFFNESS IN

CA

LF MU

SCLE W

EAK

NESS

NIELS W

ATERV

AL

UITNODIGINGvoor het bijwonen van de openbare verdediging van

het proefschrift

OPTIMIZING ANKLE FOOT

ORTHOSIS STIFFNESS IN CALF MUSCLE

WEAKNESS

doorNiels Waterval

op vrijdag 24 april om 12:00 uur

in de Agnietenkapel, Oudezijds Voorburgwal 231,

in Amsterdam.

Na afloop bent u van harte uitgenodigd om te proosten

bij de receptie.

PARANIMFEN Bob Radder

Jamal Roskam

Calf muscle weakness is commonly present in people with neuromuscular diseases, impairing their gait. To counteract this, and improve their gait, ankle foot orthoses (AFO) are regularly prescribed. The effectiveness of an AFO to promote gait depends on its mechanical properties like stiffness, but evidence about how this affects gait is scarce. Therefore, the aim of this thesis was 1) to quantify the effect of AFO stiffness on gait in these patients, and 2) to study whether AFO stiffness optimization improves their gait performance beyond current usual care. Results demonstrate that AFOs provided in usual care often have a suboptimal stiffness. The AFO stiffness that best improves gait differs between individuals. Walking energy cost, walking speed and fatigue improved most after optimizing the AFO stiffness for each patient individually. Based on these outcomes, a precision orthotics prescription for people with calf muscle weakness should include individually optimized AFO stiffness.

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OPTIMIZING ANKLE FOOT

ORTHOSIS STIFFNESS IN

CALF MUSCLE WEAKNESS

Niels Waterval

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Optimizing ankle foot orthosis stiffness in calf muscle weakness.Doctoral thesis, University of Amsterdam, The Netherlands

ISBN: 9789464021301Copyright: © by Niels Waterval. All rights reserved. No part of this thesis

may be reproduced, stored in a retrieval system or transmitted in any form or by any means without the written permission from the author or publishers of the included scientific papers.

Cover design: Gildeprint – The NetherlandsLayout & Printed by: Gildeprint – Then Netherlands

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Optimizing ankle foot orthosis stiffness in calf muscle weakness

ACADEMISCH PROEFSCHRIFT

ter verkrijging van de graad van doctoraan de Universiteit van Amsterdamop gezag van de Rector Magnificus

prof. dr. ir. K.I.J. Maexten overstaan van een door het College voor Promoties ingestelde commissie,

in het openbaar te verdedigenop vrijdag 24 april 2020, te 12.00 uur

door

Nicolaas Franciscus Johannes Watervalgeboren te Woudenberg

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PROMOTIECOMMISSIE

Promotores: Prof. dr. F. Nollet AMC-UvA Prof. dr. ir. J. Harlaar Vrije Universiteit Amsterdam

Copromotor: Dr. M.A. Brehm AMC-UvA

Overige leden: Prof. dr. C.A.M. van Bennekom AMC-UvA Prof. dr. M.G.W. Dijkgraaf AMC-UvA Dr. J. Raaphorst AMC-UvA Dr. ir. J.C. van den Noort AMC-UvA Prof. dr.-ing. H. Vallery TU Delft Prof. dr. V. de Groot Vrije Universiteit Amsterdam

Faculteit der Geneeskunde

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This PhD thesis was embedded within Amsterdam Movement Sciences research institute, at the Department of Rehabilitation, Amsterdam UMC, University of Amsterdam, the Netherlands.

The studies presented in this work were supported by:Prinses Beatrix spierfondsOIM OrthopedieLivit OrthopedieOttobock

Printing of this thesis was financially supported by:OIM Orthopedie | www.oim.nl Cosmed Benelux B.V. | www.cosmed.comOttobock | www.ottobock.nl Össur | www.ossur.comLivit Orthopedie | www.livit.nl

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CONTENT

Chapter 1General introduction.

9

Chapter 2Compensations in lower limb joint work during walking in response to unilateral calf muscle weakness.

23

Chapter 3Description of orthotic properties and effect evaluation of a ankle foot orthoses in non-spastic calf muscle weakness.

43

Chapter 4Stiffness modification of two ankle foot orthosis types to optimize gait in individuals with noon-spastic calf muscle weakness- a proof-of-concept study.

67

Chapter 5Modifying ankle foot orthosis stiffness in persons with calf muscle weakness: gait responses on group and individual level.

93

Chapter 6Precision orthotics: optimizing ankle foot orthoses to improve gait in patients with neuromuscular diseases; protocol of the PROOF-AFO study, a prospective intervention study.

113

Chapter 7Stiffness-optimized ankle foot orthoses improve metabolic walking energy cost compared to regular prescribed orthoses in persons with neuromuscular disorders; a prospective uncontrolled intervention study.

133

Chapter 8General discussion.

157

SummarySamenvattingDankwoordCurriculum Vitae & portfolioContributions of authors

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