Orthotic Device Research

Orthoses are assistive devices that support joints through alignment, stabilization, or assisting weakened musculature. The cost associated with orthotic treatment is substantial, and the demand is outpacing the supply. Patient comfort and performance are influenced by orthosis fit (size or shape) as well as function (mechanical aspects). To achieve optimal performance outcomes, an orthosis must be customized to the individual patient. However, traditional fabrication methods do not readily support the objective prescription and manufacture of orthosis mechanical aspects. There is a need for processes that promote better patient outcomes. Here, we seek to identify promising approaches, contemporary methods, and existing gaps that may provide enhanced benefit and value to the orthotic user. This chapter examines the current state of patient care practices as well as cutting-edge research and technologies primarily associated with ankle-foot orthoses.

[1]  John F Kragh,et al.  Characterization of Extremity Wounds in Operation Iraqi Freedom and Operation Enduring Freedom , 2007, Journal of orthopaedic trauma.

[2]  Daniel P. Ferris,et al.  A pneumatically powered knee-ankle-foot orthosis (KAFO) with myoelectric activation and inhibition , 2009, Journal of NeuroEngineering and Rehabilitation.

[3]  Joseph C Wenke,et al.  Comparative effect of orthosis design on functional performance. , 2012, The Journal of bone and joint surgery. American volume.

[4]  D. Condie,et al.  The modern era of orthotics , 2008, Prosthetics and orthotics international.

[5]  Jari Pallari,et al.  Embracing additive manufacture: implications for foot and ankle orthosis design , 2012, BMC Musculoskeletal Disorders.

[6]  Jicheng Xia,et al.  Technologies for Powered Ankle-Foot Orthotic Systems: Possibilities and Challenges , 2013, IEEE/ASME Transactions on Mechatronics.

[7]  R S Ross,et al.  A three centre study of the variability of ankle foot orthoses due to fabrication and grade of polypropylene , 2004, Prosthetics and orthotics international.

[8]  Daan J J Bregman,et al.  Studies Examining the Efficacy of Ankle Foot Orthoses should Report Activity Level and Mechanical Evidence , 2010, Prosthetics and orthotics international.

[9]  Steven J. Stanhope,et al.  Passive-Dynamic Ankle–Foot Orthoses Substitute for Ankle Strength While Causing Adaptive Gait Strategies: A Feasibility Study , 2014, Annals of Biomedical Engineering.

[10]  Joseph C. Wenke,et al.  The Changing Face of Disability in the US Army: The Operation Enduring Freedom and Operation Iraqi Freedom Effect , 2012, The Journal of the American Academy of Orthopaedic Surgeons.

[11]  B. Pomeranz,et al.  Prosthetics and orthotics for the older adult with a physical disability. , 2006, Clinics in geriatric medicine.

[12]  Elaine Owen,et al.  The Importance of Being Earnest about Shank and Thigh Kinematics Especially When Using Ankle-Foot Orthoses , 2010, Prosthetics and orthotics international.

[13]  J Perry,et al.  Biomechanical abnormalities of post-polio patients and the implications for orthotic management. , 1997, NeuroRehabilitation.

[14]  James Woodburn,et al.  The use of 3D surface scanning for the measurement and assessment of the human foot , 2010, Journal of foot and ankle research.

[15]  Robert Riener,et al.  Control strategies for active lower extremity prosthetics and orthotics: a review , 2015, Journal of NeuroEngineering and Rehabilitation.

[16]  Richard H. Crawford,et al.  Manufacture of Passive Dynamic Ankle–Foot Orthoses Using Selective Laser Sintering , 2008, IEEE Transactions on Biomedical Engineering.

[17]  H. Herr,et al.  Adaptive control of a variable-impedance ankle-foot orthosis to assist drop-foot gait , 2004, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[18]  S. Miyazaki,et al.  Effect of ankle-foot orthosis on active ankle moment in patients with hemiparesis , 1997, Medical and Biological Engineering and Computing.

[19]  Robert A. Bedotto,et al.  Biomechanical assessment and treatment in lower extremity prosthetics and orthotics: a clinical perspective. , 2006, Physical medicine and rehabilitation clinics of North America.

[20]  Jos Vander Sloten,et al.  SLS Nylon 12 characterisation through tensile testing and digital image correlation for finite element modelling of foot and ankle-foot orthoses , 2010 .

[21]  Nachiappan Chockalingam,et al.  The effect of tuning ankle foot orthoses–footwear combination on the gait parameters of children with cerebral palsy , 2013, Prosthetics and orthotics international.

[22]  K. Ball,et al.  Evolution of foot orthotics--part 2: research reshapes long-standing theory. , 2002, Journal of manipulative and physiological therapeutics.

[23]  G. Doxey,et al.  Clinical use and fabrication of molded thermoplastic foot orthotic devices. Suggestion from the field. , 1985, Physical therapy.

[24]  Brett D Owens,et al.  Resource Utilization and Disability Outcome Assessment of Combat Casualties From Operation Iraqi Freedom and Operation Enduring Freedom , 2009, Journal of orthopaedic trauma.

[25]  S. Collins,et al.  The effect of ankle foot orthosis stiffness on the energy cost of walking: a simulation study. , 2011, Clinical biomechanics.

[26]  Y Suzuki,et al.  Stiffness control in posterior-type plastic ankle-foot orthoses: Effect of ankle trimline Part 2: Orthosis characteristics and orthosis/patient matching , 1996, Prosthetics and orthotics international.

[27]  Richard Moore,et al.  Assessment of a virtual functional prototyping process for the rapid manufacture of passive-dynamic ankle-foot orthoses. , 2013, Journal of biomechanical engineering.

[28]  Elena M Gutierrez-Farewik,et al.  A new carbon fibre spring orthosis for children with plantarflexor weakness. , 2007, Gait & posture.

[29]  Joan E Sanders,et al.  Central fabrication: carved positive assessment , 2011, Prosthetics and orthotics international.

[30]  A. Timmermans,et al.  Technology-assisted training of arm-hand skills in stroke: concepts on reacquisition of motor control and therapist guidelines for rehabilitation technology design , 2009, Journal of NeuroEngineering and Rehabilitation.

[31]  Toshiki Kobayashi,et al.  Techniques to measure rigidity of ankle-foot orthosis: a review. , 2011, Journal of rehabilitation research and development.

[32]  Nachiappan Chockalingam,et al.  Effects of foot orthoses: How important is the practitioner? , 2012, Gait & posture.

[33]  Hiroshi Mizoguchi,et al.  Design and Control of a Wearable Stewart Platform-Type Ankle-Foot Assistive Device , 2012 .

[34]  Daniel P Ferris,et al.  Invariant ankle moment patterns when walking with and without a robotic ankle exoskeleton. , 2010, Journal of biomechanics.

[35]  Jason Allan Ramsey,et al.  Development of a method for fabricating polypropylene non-articulated dorsiflexion assist ankle foot orthoses with predetermined stiffness , 2011, Prosthetics and orthotics international.

[36]  Matthew T.G. Pain,et al.  A Methodology to Investigate the Relationship between Lower-Limb Dynamics and Shoe Stiffness Using Custom-Built Footwear , 2011 .

[37]  S. Gard,et al.  The human ankle during walking: implications for design of biomimetic ankle prostheses. , 2004, Journal of biomechanics.

[38]  Steven J. Stanhope,et al.  Estimates of Stiffness for Ankle-Foot Orthoses Are Sensitive to Loading Conditions , 2010 .

[39]  D G Smith,et al.  The use of CAD/CAM technology in prosthetics and orthotics--current clinical models and a view to the future. , 2001, Journal of rehabilitation research and development.

[40]  Steven J Stanhope,et al.  Dimensional accuracy of ankle-foot orthoses constructed by rapid customization and manufacturing framework. , 2011, Journal of rehabilitation research and development.

[41]  Ronald J. Triolo,et al.  A Variable Impedance Knee Mechanism for Controlled Stance Flexion During Pathological Gait , 2012, IEEE/ASME Transactions on Mechatronics.

[42]  Eric Loth,et al.  A pneumatic power harvesting ankle-foot orthosis to prevent foot-drop , 2009, Journal of NeuroEngineering and Rehabilitation.

[43]  J. Harlaar,et al.  Spring-like Ankle Foot Orthoses reduce the energy cost of walking by taking over ankle work. , 2012, Gait & posture.

[44]  J. Geertzen,et al.  Development of Clinical Guidelines for the Prescription of Orthoses in Patients with Neurological Disorders in The Netherlands , 2006, Prosthetics and orthotics international.

[45]  Yasushi Akazawa,et al.  Design of a stiffness-adjustable ankle-foot orthosis and its effect on ankle joint kinematics in patients with stroke. , 2011, Gait & posture.

[46]  Javaid Iqbal,et al.  On the Improvement of Multi-Legged Locomotion over Difficult Terrains Using a Balance Stabilization Method: , 2012 .

[47]  Jaap Harlaar,et al.  A candidate core set of outcome measures based on the international classification of functioning, disability and health for clinical studies on lower limb orthoses , 2011, Prosthetics and orthotics international.

[48]  Gi Dae Kim,et al.  A benchmark study on rapid prototyping processes and machines: Quantitative comparisons of mechanical properties, accuracy, roughness, speed, and material cost , 2008 .

[49]  Gregory S Sawicki,et al.  A neuromechanics-based powered ankle exoskeleton to assist walking post-stroke: a feasibility study , 2015, Journal of NeuroEngineering and Rehabilitation.

[50]  Richard Baker,et al.  A Systematic Review to Determine Best Practice Reporting Guidelines for AFO Interventions in Studies Involving Children with Cerebral Palsy , 2010, Prosthetics and orthotics international.

[51]  J Harlaar,et al.  A new method for evaluating ankle foot orthosis characteristics: BRUCE. , 2009, Gait & posture.

[52]  Daniel P. Ferris,et al.  Learning to walk with a robotic ankle exoskeleton. , 2007, Journal of biomechanics.

[53]  B. Malas,et al.  What Variables Influence the Ability of an AFO to Improve Function and When Are They Indicated? , 2011, Clinical orthopaedics and related research.

[54]  Vimal Dhokia,et al.  Manufacturing methodology for personalised symptom-specific sports insoles , 2009 .

[55]  Kai-Ming Chan,et al.  Evaluation of combined prescription of rocker sole shoes and custom-made foot orthoses for the treatment of plantar fasciitis. , 2012, Clinical biomechanics.

[56]  Kenneth W. Dalgarno,et al.  Mass Customization of Foot Orthoses for Rheumatoid Arthritis Using Selective Laser Sintering , 2010, IEEE Transactions on Biomedical Engineering.

[57]  Scott Telfer,et al.  Computer-aided design of customized foot orthoses: reproducibility and effect of method used to obtain foot shape. , 2012, Archives of physical medicine and rehabilitation.

[58]  Kavi C Jagadamma,et al.  The Effects of Tuning an Ankle-Foot Orthosis Footwear Combination on Kinematics and Kinetics of the Knee Joint of an Adult with Hemiplegia , 2010, Prosthetics and orthotics international.

[59]  Paolo Bonato,et al.  Patient specific ankle-foot orthoses using rapid prototyping , 2011, Journal of NeuroEngineering and Rehabilitation.

[60]  Yasushi Akazawa,et al.  The effect of varying the plantarflexion resistance of an ankle-foot orthosis on knee joint kinematics in patients with stroke. , 2013, Gait & posture.