Comprehensive gait characteristics on electromagnetic stance-control knee ankle foot orthosis in healthy individuals

Abstract

Abstract Computer-controlled knee ankle foot orthosis (KAFO) has the potential to contribute to gait training and functional walking assistance by ensuring knee stability during stance while allowing knee flexion during swing; however, evidence regarding the gait characteristics associated with computer-controlled KAFO remains limited. This study comprehensively investigated gait using an electromagnetic stance-control KAFO from the perspectives of kinematics, kinetics, frontopolar cortex (FPC) activity, and subjective difficulty. Twenty healthy participants were evaluated under four walking conditions: walking without an orthosis (WO), KAFO with electromagnetic stance-control on (EKAFO-on), KAFO with electromagnetic stance-control off (EKAFO-off), and KAFO with the knee joint locked (EKAFO-lock). Compared with EKAFO-lock, EKAFO-on demonstrated significantly greater peak knee flexion during swing (69.2 ± 8.7° vs. 15.7 ± 3.6°) and gait patterns that more closely resembled WO and EKAFO-off in terms of kinematics and kinetics. No clear differences in FPC activity were observed among the four walking conditions. Subjective difficulty, assessed using a seven-point Likert scale, was significantly higher in EKAFO-on (4.9) and EKAFO-lock (5.4) than in WO (1.1). These findings suggest that electromagnetic stance-control KAFO enables gait patterns that more closely resemble walking without an orthosis; however, the higher perceived difficulty remains a challenge for clinical application.