ArticleJournal of neuroengineering and rehabilitation2021
Individual stiffness optimization of dorsal leaf spring ankle-foot orthoses in people with calf muscle weakness is superior to standard bodyweight-based recommendations.
Article in Journal of neuroengineering and rehabilitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Ankle-foot orthoses for improving walking in adults with calf muscle weakness due to neuromuscular disorders.The Cochrane database of systematic reviews · 2025Pooled it
- Ankle-foot orthosis mechanical testing: a scoping review.Journal of neuroengineering and rehabilitation · 2026Article
- An integrated multi-variable optimization approach to tailor ankle-foot orthosis stiffness to end-user needs.Journal of neuroengineering and rehabilitation · 2026Article
- Customized passive-dynamic ankle-foot orthoses can improve walking economy and speed for many individuals post-stroke.Journal of neuroengineering and rehabilitation · 2024Article
- Walking with unilateral ankle-foot unloading: a comparative biomechanical analysis of three assistive devices.Journal of neuroengineering and rehabilitation · 2024Article
- A proposed evidence-guided algorithm for the adjustment and optimization of multi-function articulated ankle-foot orthoses in the clinical setting.Frontiers in rehabilitation sciences · 2024Article
- Ankle dorsiflexion assistance of patients with foot drop using a powered ankle-foot orthosis to improve the gait asymmetry.Journal of neuroengineering and rehabilitation · 2023Article
- Design principles, manufacturing and evaluation techniques of custom dynamic ankle-foot orthoses: a review study.Journal of foot and ankle research · 2022Review
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 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.
methodsThirty-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.
resultsIn 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.
conclusionsIn 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 .
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