Abstract

Ankle-foot orthoses (AFOs) are frequently used to improve walking in a variety of diseases. The effect of such interventions relies on adequate prescription. This symposium provides insights from recent studies focusing on both optimizing timing of prescription and optimizing biomechanical properties of the AFO.

A recent study on the timing of AFO-provision after stroke showed that early AFO-provision results in functional improvements over time. These improvements were achieved without changes in affected limb kinematics or muscle-activity. This suggests that compensation mechanisms are important and highlights the importance of the unaffected leg in rehabilitation therapy. To improve the affected leg function, new AFO-designs should be considered.

Conventional AFOs also have disadvantages. For example, often too stiff AFOs are prescribed. These AFOs are less comfortable and restrict ankle movement, also in patients who potentially have some residual muscle strength. By restricting ankle plantarflexion movement, also ankle power is reduced. AFO-preference from literature, patient-perspectives on AFO-designs and the design of a new AFO taking both patient-perspective and biomechanics into account are presented in this symposium.

With respect to AFO-use, much attention has been paid to optimizing range of motion and stiffness around the ankle. From a biomechanical perspective however, the properties of the AFO footplate are just as important, as the leverage of the foot determines the loading of the ankle joint. In the final contribution of the symposium, the biomechanical effects of AFO footplate stiffness on ankle motion and foot and ankle power during the stance phase of gait will be demonstrated.

Statement of the objective / learning objectives

1. The effect of timing of AFO-provision after stroke on gait kinematics and EMG
2. Patient-perspectives and biomechanical aspects of AFO design
3. Importance of AFO footplate stiffness on foot and ankle power during gait

This session focuses on the topic Orthotics: Lower Limb Neurological.