2.06 Precision orthotics: Evidence and new technologies to individualise ankle foot orthosis stiffness

Location: Tonalá, Second floor



In many diseases such as neuromuscular disorders and cerebral palsy, ankle foot orthoses (AFOs) are applied to normalize the gait pattern and augment walking ability. However, a large percentage of the provided AFOs do not normalize the gait pattern and/or improve walking ability, leading to suboptimal treatment effects and non-use. As the effect of AFOs on improving gait depends largely on their mechanical properties, an inadequate match between AFO properties and patient impairments can explain part of this ineffectiveness. To maximize treatment effects of AFOs, the stiffness needs to be optimized for each individual user, which we have coined Precision Orthotics.

In this symposium, we will demonstrate the beneficial effects of applying Precision Orthotics in the prescription of AFOs as demonstrated by clinical trials in Cerebral Palsy, Neuromuscular diseases and Neurological disorders. Thereafter, we will demonstrate two innovative techniques that are currently being developed to optimize AFOs quickly. Regarding the first technique, a demonstration about how forward dynamic simulations work, what they have learned us about AFO individualization and how they might be used to predict the optimal AFO stiffness will be given. With regards to the second technique, we show a newly developed stiffness-adjustable AFO for which the stiffness can be changed instantaneous during walking. This allows for a rapid optimization procedure, making it easier to implement optimization of AFO stiffness in daily practice. The first tests with the ADJUST-AFO will be conducted in the winter of 2022.

Statement of the objective / learning objectives

Participants will learn about the beneficial effects of Precision Orthotics and become familiar with innovative techniques to implement Precision Orthotics in clinical practice in the near future.


Niels Waterval
Amsterdam UMC, Amsterdam, Netherlands


Merel Brehm
Amsterdam UMC, Amsterdam, Netherlands

Event Location

Tonalá, Second floor