Personalised Ankle-Foot Orthoses design based on Reverse Engineering

2006 ◽  
pp. 253-257 ◽  
Author(s):  
S.M. Milusheva ◽  
E.Y. Tosheva ◽  
L.C. Hieu ◽  
L.V. Kouzmanov ◽  
N. Zlatov ◽  
...  
Keyword(s):  
Reverse Engineering ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses

scholarly journals Individual stiffness optimization of dorsal leaf spring ankle–foot orthoses in people with calf muscle weakness is superior to standard bodyweight-based recommendations

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Niels F. J. Waterval ◽  
Merel-Anne Brehm ◽  
Jaap Harlaar ◽  
Frans Nollet
Keyword(s):  
Muscle Weakness ◽  
Energy Cost ◽  
Activity Level ◽  
Calf Muscle ◽  
Leaf Spring ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses ◽  
The Individual ◽  
Optimal Stiffness ◽  
Walking Energy Cost

Abstract Background In people with calf muscle weakness, the stiffness of dorsal leaf spring ankle–foot orthoses (DLS-AFO) needs to be individualized to maximize its effect on walking. Orthotic suppliers may recommend a certain stiffness based on body weight and activity level. However, it is unknown whether these recommendations are sufficient to yield the optimal stiffness for the individual. Therefore, we assessed whether the stiffness following the supplier’s recommendation of the Carbon Ankle7 (CA7) dorsal leaf matched the experimentally optimized AFO stiffness. Methods Thirty-four persons with calf muscle weakness were included and provided a new DLS-AFO of which the stiffness could be varied by changing the CA7® (Ottobock, Duderstadt, Germany) dorsal leaf. For five different stiffness levels, including the supplier recommended stiffness, gait biomechanics, walking energy cost and speed were assessed. Based on these measures, the individual experimentally optimal AFO stiffness was selected. Results In only 8 of 34 (23%) participants, the supplier recommended stiffness matched the experimentally optimized AFO stiffness, the latter being on average 1.2 ± 1.3 Nm/degree more flexible. The DLS-AFO with an experimentally optimized stiffness resulted in a significantly lower walking energy cost (− 0.21 ± 0.26 J/kg/m, p < 0.001) and a higher speed (+ 0.02 m/s, p = 0.003). Additionally, a larger ankle range of motion (+ 1.3 ± 0.3 degrees, p < 0.001) and higher ankle power (+ 0.16 ± 0.04 W/kg, p < 0.001) were found with the experimentally optimized stiffness compared to the supplier recommended stiffness. Conclusions In people with calf muscle weakness, current supplier’s recommendations for the CA7 stiffness level result in the provision of DLS-AFOs that are too stiff and only achieve 80% of the reduction in energy cost achieved with an individual optimized stiffness. It is recommended to experimentally optimize the CA7 stiffness in people with calf muscle weakness in order to maximize treatment outcomes. Trial registration Nederlands Trial Register 5170. Registration date: May 7th 2015. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5170.

State of the Art Review of Knee–Ankle–Foot Orthoses

2015 ◽  
Vol 43 (2) ◽  
pp. 427-441 ◽  
Author(s):  
Feng Tian ◽  
Mohamed Samir Hefzy ◽  
Mohammad Elahinia
Keyword(s):  
State Of The Art ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses

Quantification of gait asymmetry in patients with ankle foot orthoses based on hip–hip cyclograms

2014 ◽  
Vol 34 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Patrik Kutilek ◽  
Vladimir Socha ◽  
Slavka Viteckova ◽  
Zdenek Svoboda
Keyword(s):  
Foot Orthoses ◽  
Ankle Foot Orthoses ◽  
Gait Asymmetry

scholarly journals The Importance of Being Earnest about Shank and Thigh Kinematics Especially When Using Ankle-Foot Orthoses

2010 ◽  
Vol 34 (3) ◽  
pp. 254-269 ◽  
Author(s):  
Elaine Owen
Keyword(s):  
Joint Kinematics ◽  
Foot Orthoses ◽  
Traditional Beliefs ◽  
Vertical Angle ◽  
Gait Biomechanics ◽  
Normal Gait ◽  
Ankle Foot Orthoses ◽  
Pathological Gait ◽  
Kinematics And Kinetics

This paper reviews and summarizes the evidence for important observations of normal and pathological gait and presents an approach to rehabilitation and orthotic management, which is based on the significance of shank and thigh kinematics for standing and gait. It discusses normal gait biomechanics, challenging some traditional beliefs, the interrelationship between segment kinematics, joint kinematics and kinetics and their relationship to orthotic design, alignment and tuning. It proposes a description of four rather than three rockers in gait; a simple categorization of pathological gait based on shank kinematics abnormality; an algorithm for the designing, aligning and tuning of AFO-Footwear Combinations; and an algorithm for determining the sagittal angle of the ankle in an AFO. It reports the results of research on Shank to Vertical Angle alignment of tuned AFO-Footwear Combinations and on the use of ‘point loading’ rocker soles.

Effects of Ankle-Foot Orthoses for Children with Hemiplegia on Weight-Bearing and Functional Ability

2009 ◽  
Vol 21 (3) ◽  
pp. 225-234 ◽  
Author(s):  
Tara O’Reilly ◽  
Adrienne Hunt ◽  
Bronwyn Thomas ◽  
Lynne Harris ◽  
Joshua Burns
Keyword(s):  
Functional Ability ◽  
Weight Bearing ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses

Development of a Testing Apparatus for Structural Stiffness Evaluation of Ankle-Foot Orthoses

2001 ◽  
Vol 13 (3) ◽  
pp. 74-82 ◽  
Author(s):  
Adrian A. Polliack ◽  
Christopher Swanson ◽  
Samuel E. Landsberger ◽  
Donald R. McNeal
Keyword(s):  
Foot Orthoses ◽  
Structural Stiffness ◽  
Testing Apparatus ◽  
Stiffness Evaluation ◽  
Ankle Foot Orthoses

In-Shoe Plantar Pressures Within Ankle-Foot Orthoses

2011 ◽  
Vol 39 (12) ◽  
pp. 2679-2685 ◽  
Author(s):  
Rebecca S. Kearney ◽  
Sarah E. Lamb ◽  
Juul Achten ◽  
Nicholas R. Parsons ◽  
Matthew L. Costa
Keyword(s):  
Achilles Tendon ◽  
Plantar Pressure ◽  
Clinical Management ◽  
Achilles Tendon Rupture ◽  
Foot Orthoses ◽  
Pressure Measurements ◽  
Clinical Context ◽  
Functional Benefit ◽  
Gait Parameters ◽  
Ankle Foot Orthoses

Background: Advances in the management of Achilles tendon rupture have led to the development of immediate weightbearing protocols. These vary regarding which ankle-foot orthoses (AFOs) are used and the number of inserted heel wedges used within them. Purpose: This study was conducted to evaluate plantar pressure measurements and temporal gait parameters within different AFOs, using different numbers of heel wedges. Study Design: Controlled laboratory study. Methods: Fifteen healthy participants were evaluated using 3 different AFOs, with 4 different levels of inserted heel wedges. Therefore, a total of 12 conditions were evaluated, in a sequence that was randomly allocated to each participant. Pressure and temporal gait parameters were measured using an in-shoe F-Scan pressure system, and range of movement was measured using an electrogoniometer. Results: Ankle-foot orthoses that were restrictive in design, combined with a higher number of inserted heel wedges, reduced forefoot pressures, increased heel pressures, and decreased the amount of time spent in the terminal stance and preswing phase of the gait cycle ( P = .029, .002, and .001). Conclusion: The choice of AFO design and the number of inserted heel wedges have a significant effect on plantar pressure measurements and temporal gait parameters. The implications of these changes need to be applied to the clinical management of acute Achilles tendon ruptures. This clinical management requires a balance between protected weightbearing and functional loading, requiring further research within a clinical context. Clinical Relevance: The biomechanical data from this research imply that a carbon-fiber AFO, with 1 heel raise, protects against excessive dorsiflexion while facilitating the restoration of near-normal gait parameters. This could lead to an accelerated return to function, avoiding the effects of disuse atrophy. This is in contrast to the rigid rocker-bottom AFO design with a greater number of heel-wedge inserts. However, research within a clinical context would be required to ascertain if these biomechanical advantages translate into a functional benefit for patients. The results should also be considered in relation to the amount of force a healing Achilles tendon can withstand.

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