1.The effect of ankle foot orthotics at different angles on knee hyperextension in spinal cord injury
Zhixi SHI ; Shengpu YU ; Junshi TU
Chinese Journal of Rehabilitation Medicine 2025;40(2):243-247
Objective:To observe the effects of ankle-foot orthoses(AFOs)on knee hyperextension in patients with incom-plete spinal cord injuries(C-D grades).Method:From June 2022 to January 2024,31 patients with C-D grade incomplete spinal cord injuries accom-panied by varying degrees of knee hyperextension were admitted to our hospital,including 16 males and 15 fe-males aged between 28 and 55 years(mean age:39.69±11.98).Based on pre-set criteria,patients were divided into a mild group(30 patients with knee hyperextension of 6°—10°)and a moderate group(25 patients with knee hyperextension of 11°—20°).Both groups were fitted with AFOs designed to correct knee hyperextension,featuring three types of ankle joint angles:0°,5° dorsiflexion,and 10° dorsiflexion.Knee hyperextension was measured and analyzed after fitting all three types of AFOs in both groups,allowing for within-group and be-tween-group comparisons of improvement.Result:Significant differences in knee hyperextension angles were observed between the two groups before wearing the orthoses.However,these differences became statistically non-significant after wearing AFOs with an-kle angles of 0°,5°,and 10°.Additionally,repeated measures ANOVA revealed significant differences in knee hyperextension improvement among different groups and when wearing AFOs with different ankle angles,but the interaction effect between group and AFO angle was not significant.Further simple effect tests showed sig-nificant differences in knee hyperextension improvement when wearing AFOs at various angles within both groups,and there were also significant differences in the effects of different AFO angles on knee hyperexten-sion improvement within the mild and moderate groups.Multiple comparisons revealed that,in both the mild and moderate groups,wearing AFOs with ankle angles of 0°,5°,and 10° resulted in a significant stepwise in-crease in knee hyperextension improvement.Conclusion:The results indicate that AFOs are effective in treating knee hyperextension in patients with C-D grade incomplete spinal cord injuries,regardless of the severity(mild or moderate).Moreover,the greater the ankle dorsiflexion angle,the better the correction effect on knee hyperextension.However,it should be noted that AFOs with a 10° dorsiflexion angle may lead to overcorrection and knee flexion.
2.The effect of ankle foot orthotics at different angles on knee hyperextension in spinal cord injury
Zhixi SHI ; Shengpu YU ; Junshi TU
Chinese Journal of Rehabilitation Medicine 2025;40(2):243-247
Objective:To observe the effects of ankle-foot orthoses(AFOs)on knee hyperextension in patients with incom-plete spinal cord injuries(C-D grades).Method:From June 2022 to January 2024,31 patients with C-D grade incomplete spinal cord injuries accom-panied by varying degrees of knee hyperextension were admitted to our hospital,including 16 males and 15 fe-males aged between 28 and 55 years(mean age:39.69±11.98).Based on pre-set criteria,patients were divided into a mild group(30 patients with knee hyperextension of 6°—10°)and a moderate group(25 patients with knee hyperextension of 11°—20°).Both groups were fitted with AFOs designed to correct knee hyperextension,featuring three types of ankle joint angles:0°,5° dorsiflexion,and 10° dorsiflexion.Knee hyperextension was measured and analyzed after fitting all three types of AFOs in both groups,allowing for within-group and be-tween-group comparisons of improvement.Result:Significant differences in knee hyperextension angles were observed between the two groups before wearing the orthoses.However,these differences became statistically non-significant after wearing AFOs with an-kle angles of 0°,5°,and 10°.Additionally,repeated measures ANOVA revealed significant differences in knee hyperextension improvement among different groups and when wearing AFOs with different ankle angles,but the interaction effect between group and AFO angle was not significant.Further simple effect tests showed sig-nificant differences in knee hyperextension improvement when wearing AFOs at various angles within both groups,and there were also significant differences in the effects of different AFO angles on knee hyperexten-sion improvement within the mild and moderate groups.Multiple comparisons revealed that,in both the mild and moderate groups,wearing AFOs with ankle angles of 0°,5°,and 10° resulted in a significant stepwise in-crease in knee hyperextension improvement.Conclusion:The results indicate that AFOs are effective in treating knee hyperextension in patients with C-D grade incomplete spinal cord injuries,regardless of the severity(mild or moderate).Moreover,the greater the ankle dorsiflexion angle,the better the correction effect on knee hyperextension.However,it should be noted that AFOs with a 10° dorsiflexion angle may lead to overcorrection and knee flexion.

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