Publications by authors named "J Wilken"

Background: Carbon fiber custom dynamic orthoses have been used to improve gait mechanics after lower limb trauma in military service members, with the goal of restoring function and improving outcomes. However, the effects of commercially available carbon fiber orthoses available to civilians on lower extremity joint kinetics and kinematics are poorly understood.

Research Question: The aim of this study was to examine the effect of two commercially available orthoses on lower extremity kinematics and kinetics in individuals with lower limb trauma.

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Article Synopsis
  • Post-traumatic osteoarthritis (PTOA) often arises after tibial pilon fractures, leading surgeons to prioritize precise articular reduction, which can extend surgery time.
  • A cadaveric study explored how the stiffness of custom dynamic orthoses (CDOs) affects ankle joint reaction force (JRF) and contact stress during the stance phase of walking.
  • Results showed that using CDOs reduced JRF by up to 32%, indicating that post-operative bracing could lower the risk of developing PTOA after such fractures.
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Stiffness-customized passive-dynamic ankle-foot orthoses (PD-AFOs) have been shown to reduce the mechanical cost of transport (COT) of individuals post-stroke. However, the mechanisms underlying this reduced COT are unknown. Therefore, this study aimed to identify the factors driving COT reduction with PD-AFO use for individuals post-stroke.

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The ankle infrequently develops primary osteoarthritis (OA), especially when compared to the hip and the knee. Ankle OA instead generally develops only after trauma. The consequences of end-stage ankle OA can nonetheless be extremely debilitating, with impairment comparable to that of end-stage kidney disease or congestive heart failure.

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Background: Passive-dynamic ankle-foot orthoses (PD-AFOs) are often prescribed to address plantar flexor weakness during gait, which is commonly observed after stroke. However, limited evidence is available to inform the prescription guidelines of PD-AFO bending stiffness. This study assessed the extent to which PD-AFOs customized to match an individual's level of plantar flexor weakness influence walking function, as compared to No AFO and their standard of care (SOC) AFO.

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