The effects of knee and ankle flexion on ground clearance in paraplegic gait

Objective. To investigate the effects of knee flexion and ankle dorsiflexio n on ground clearance during the swing phase of paraplegic gait. Background Limitations of currently available walking orthoses are high ene rgy consumption and upper limb loading. Knee flexion in the swing phase has been suggested as a means of reducing these. Methods. Kinematic data of paraplegic gait in two currently available ortho ses were used to simulate the effects of knee flexion and ankle dorsiflexio n on the swing foot ground clearance. This was used to validate a mathemati cal model of a simple ideal gait that was also developed. Results. It was shown that the implementation of knee flexion alone leads t o a loss or no change in ground clearance. Implementing knee flexion and an kle dorsiflexion can be used to increase ground clearance. Conclusion. Flexion at the knee and ankle during the swing phase can potent ially be used to allow a reduction in compensatory mechanisms by easing swi ng foot ground clearance. (C) 2000 Elsevier Science Ltd. All rights reserve d.