State of the Prescription Process for Dynamic Ankle-Foot Orthoses

Koller, Corey; Arch, Elisa S.

doi:10.1007/s40141-018-0177-x

Cited by 8 publications

(3 citation statements)

References 41 publications

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“…Over the last 10 years, there have been significant advances in offloading ankle/foot orthosis designs that have allowed people with significant lower extremity trauma to participate in higher-level activities. Dynamic AFOs are passive devices that control ankle motion and limit weight bearing through the ankle to address pain, weakness and limitations in range of motion [62][63][64] . Dynamic AFOs are typically made of carbon fiber with a pretibial shell that allows for offloading of the foot and ankle with posterior struts of variable stiffness [ Figure 3].…”

Section: Orthoses After Lower Extremity Reconstructionmentioning

confidence: 99%

Prosthetic and orthotic options for lower extremity amputation and reconstruction

Crowe¹,

Impastato²,

Donaghy³

et al. 2019

PAR

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Lower extremity injury and deformity can result from a number of etiologies. Regardless of the underlying cause, the decision to pursue amputation or reconstruction of a lower limb is challenging for both patients and practitioners. This decision is largely dependent on the patient's premorbid health and function, functional goals and preferences, and characteristics and viability of the affected limb. The role of adaptive devices following surgery should never be underestimated. Advances in prostheses and orthoses have provided patients with a wider range of options to consider when deciding between limb reconstruction and amputation. The primary goals of any adaptive device are to improve function, prevent recurrence or ulceration of the defect, and allow for use of conventional footwear and/or clothing. When a lower extremity amputation is indicated, selection of the correct level is of critical importance in order to optimize healing potential and function. Each distinct level has certain inherent prosthetic and orthotic considerations. Likewise, the application of an adaptive device following reconstruction of the lower extremity also has demonstrable benefits and must be tailored to the specific defect and procedure performed. Knowledge of available prosthetic and orthotic options is of considerable importance for the reconstructive surgeon tasked with limb salvage or resurfacing an amputated extremity. This article reviews considerations of various types of lower extremity amputation and reconstruction, and provides a framework for the role of adaptive devices following surgery.

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Section: Orthoses After Lower Extremity Reconstructionmentioning

confidence: 99%

Prosthetic and orthotic options for lower extremity amputation and reconstruction

Crowe¹,

Impastato²,

Donaghy³

et al. 2019

PAR

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show abstract

“…Optimal AFO prescription should match the needs and abilities of the user with the functional characteristics of the device. There is scant evidence to guide AFO prescription [ 5 – 7 ], and there are limited opportunities for AFO users to provide experiential input during the process. Currently, the AFO prescription process relies on prescribing clinician intuition, training, experience [ 8 ], and qualitative guides provided by manufacturers [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Currently, the AFO prescription process relies on prescribing clinician intuition, training, experience [ 8 ], and qualitative guides provided by manufacturers [ 9 ]. While broad categories of AFOs are recommended to restrict movement in specific planes or augment weakness in specific muscle groups, the clinician must ultimately select from a wide variety of options [ 5 , 6 ]. Moreover, there is a lack of objective information on AFO mechanical properties (e.g., stiffness) with inconsistent and qualitative paradigms for stiffness characterization across manufacturers (e.g., sequential numbering, arbitrary units of measurement, different colors).…”

Section: Introductionmentioning

confidence: 99%

A patient-centered ‘test-drive’ strategy for ankle-foot orthosis prescription: Protocol for a randomized participant-blinded trial

Shuman,

Hendershot,

Morgenroth

et al. 2024

PLoS ONE

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Background Ankle-foot orthoses (AFOs) are commonly used to overcome mobility limitations related to lower limb musculoskeletal injury. Despite a multitude of AFOs to choose from, there is scant evidence to guide AFO prescription and limited opportunities for AFO users to provide experiential input during the process. To address these limitations in the current prescription process, this study evaluates a novel, user-centered and personalized ‘test-drive’ strategy using a robotic exoskeleton (‘AFO emulator’) to emulate commercial AFO mechanical properties (i.e., stiffness). The study will determine if brief, in-lab trials (with emulated or actual AFOs) can predict longer term preference, satisfaction, and mobility outcomes after community trials (with the actual AFOs). Secondarily, it will compare the in-lab experience of walking between actual vs. emulated AFOs. Methods and analysis In this participant-blinded, randomized crossover study we will recruit up to fifty-eight individuals with lower limb musculoskeletal injuries who currently use an AFO. Participants will walk on a treadmill with three actual AFOs and corresponding emulated AFOs for the "in-lab” assessments. For the community trial assessment, participants will wear each of the actual AFOs for a two-week period during activities of daily living. Performance-based and user-reported measures of preference and mobility will be compared between short- and long-term trials (i.e., in-lab vs. two-week community trials), and between in-lab trials (emulated vs. actual AFOs). Trial registration The study was prospectively registered at www.clininicaltrials.gov (Clinical Trials Study ID: NCT06113159). Date: November 1st 2023. https://classic.clinicaltrials.gov/ct2/show/NCT06113159.

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Nonlinear net ankle quasi-stiffness reduces error and changes with speed but not load carried

et al. 2021

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State of the Prescription Process for Dynamic Ankle-Foot Orthoses

Cited by 8 publications

References 41 publications

Prosthetic and orthotic options for lower extremity amputation and reconstruction

Prosthetic and orthotic options for lower extremity amputation and reconstruction

A patient-centered ‘test-drive’ strategy for ankle-foot orthosis prescription: Protocol for a randomized participant-blinded trial

Nonlinear net ankle quasi-stiffness reduces error and changes with speed but not load carried

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