A study on the efficacy of AFO stiffness prescriptions

Vasiliauskaite, Eglé; Ielapi, Alessio; Beule, Matthieu De; Paepegem, Wim Van; Deckers, Jan; Vermandel, Miguel; Forward, Malcolm; Plasschaert, Frank

doi:10.1080/17483107.2019.1629114

Cited by 14 publications

(10 citation statements)

References 26 publications

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“…Only one study used a prefabricated standard AFO [32], and in the remaining custommade AFO were assigned for each participant [15,30,33,[35][36][37][38]. Recent studies suggest that the initial outcomes are the immediate biomechanical response to the effect to the physical constraint imposed by the standard AFO, particularly the AFO stiffness [19,49]. On the other hand, custom-made AFO can be optimized with fine adjustments to its design and/or to the footwear prescription, in order to focus on optimal stiffness and increase its effects on gait pattern [14,51].…”

Section: Methodological Considerations Of This Reviewmentioning

confidence: 99%

“…A bibliographic reference software manager (Mendeley V. 1. 19.3) was used to assist the selection process. Whenever the two main investigators could not reach a consensus, a third external reviewer (E.B.C.)…”

Section: Study Selectionmentioning

confidence: 99%

“…Overall, studies involving gait and kinematic analysis have indicated that pathological gait in the sagittal plane can be improved using AFO [2,18,19], however it is not consensual about what factors are improved and how they have been improved. Thus, an assessment of the biomechanical characteristics and functional ability of the participants at baseline is crucial to track existing changes during the use of AFO [20].…”

Section: Introductionmentioning

confidence: 99%

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Effects of Ankle Foot Orthoses on the Gait Patterns in Children with Spastic Bilateral Cerebral Palsy: A Scoping Review

et al. 2021

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Background: Cerebral palsy (CP) is the most common cause of motor disability in children and can cause severe gait deviations. The sagittal gait patterns classification for children with bilateral CP is an important guideline for the planning of the rehabilitation process. Ankle foot orthoses should improve the biomechanical parameters of pathological gait in the sagittal plane. Methods: A systematic search of the literature was conducted to identify randomized controlled trials (RCT) and controlled clinical trials (CCT) which measured the effect of ankle foot orthoses (AFO) on the gait of children with spastic bilateral CP, with kinetic, kinematic, and functional outcomes. Five databases (Pubmed, Scopus, ISI Web of SCIENCE, SciELO, and Cochrane Library) were searched before February 2020. The PEDro Score was used to assess the methodological quality of the selected studies and alignment with the Cochrane approach was also reviewed. Prospero registration number: CRD42018102670. Results: We included 10 studies considering a total of 285 children with spastic bilateral CP. None of the studies had a PEDro score below 4/10, including five RCTs. We identified five different types of AFO (solid; dynamic; hinged; ground reaction; posterior leaf spring) used across all studies. Only two studies referred to a classification for gait patterns. Across the different outcomes, significant differences were found in walking speed, stride length and cadence, range of motion, ground force reaction and joint moments, as well as functional scores, while wearing AFO. Conclusions: Overall, the use of AFO in children with spastic bilateral CP minimizes the impact of pathological gait, consistently improving some kinematic, kinetic, and spatial-temporal parameters, and making their gait closer to that of typically developing children. Creating a standardized protocol for future studies involving AFO would facilitate the reporting of new scientific data and help clinicians use their clinical reasoning skills to recommend the best AFO for their patients.

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Section: Methodological Considerations Of This Reviewmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of Ankle Foot Orthoses on the Gait Patterns in Children with Spastic Bilateral Cerebral Palsy: A Scoping Review

et al. 2021

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“…19 of the 63 articles were included in this review in the last phase because they met the inclusion criteria. The 19 studies included outcomes such as mechanical tests [ 15 , 19 , 20 , 21 , 22 ], finite element method (FEM) simulations [ 19 , 21 , 23 ], participant feedback (healthy participants) [ 24 , 25 , 26 ] patient feedback (non-healthy participants) [ 19 , 22 , 27 ], QUEST [ 15 , 28 ], kinematics [ 15 , 22 , 23 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], kinetics [ 23 , 26 , 30 , 31 , 32 , 35 ], observation after trial [ 27 , 36 ], dimensional accuracy [ 25 ] and EMG [ 30 , 34 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

“…Researchers have been using different types of AM printing and materials. The majority of the papers used fused deposition modeling (FDM) [ 15 , 19 , 20 , 21 , 24 , 27 , 28 , 33 , 34 ] and selective laser sintering (SLS) [ 25 , 29 , 30 , 31 , 32 , 35 , 36 ]. Multi-jet fusion (MJF) [ 22 ] and stereolithography (SLA) [ 26 ] were also used, and one manuscript did not describe the printing method [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

A Review of Additive Manufacturing Studies for Producing Customized Ankle-Foot Orthoses

et al. 2022

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Ankle-foot orthoses (AFO) are prescribed to improve the patient’s quality of life. Supporting weak muscles or restraining spastic muscles leads to smoother and more stable locomotion. Commonly, AFO are made using thermoplastic vacuum forming, which requires a long time for production and has limited design options. Additive manufacturing (AM) can solve this problem, leading to a faster and cheaper solution. This review aimed to investigate what is the state-of-art using AM for AFO. Evaluating the used manufacturing processes, customization steps, mechanical properties, and biomechanical features in humans would provide significant insights for further research. The database searches combined AM and AFO with no year or publication type restrictions. Studies must have examined outcomes on human participants with the orthoses built by AM. Other types of orthotic devices or different manufacturing techniques were excluded. Nineteen studies met the inclusion criteria. As stated by having all studies conducted in the last nine years, this is a very recent domain. Different AM processes have been used, with the majority relying on Fused Deposition Modeling. Overall, the manuscripts’ quality is deficient, which is critical to promoting further studies with higher samples. Except for one paper, AM-printed AFO was comparable or superior to the thermoplastic vacuum forming AFO in mechanical tests, kinematics, kinetics, and participant feedback.

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Comparative Analysis of Mechanical and Thermal Characteristics of 3D‐Printed Polyamide using Material Extrusion and Powder Bed Fusion Process with Industrial and Desktop Printers

Told,

Kardos,

Paari‐Molnar

et al. 2024

Macro Materials & Eng

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Polyamide (PA) has excellent mechanical properties, making it versatile in various applications, including 3D printing. This paper comprehensively investigates and compares the mechanical, structural, thermal, and geometric properties of 3D‐printed PA12 samples produced with desktop and industrial printers using material extrusion (MEX) and powder bed fusion (PBF) processes. The mechanical tests included tensile, flexural, Charpy impact, Shore hardness, torsion, and water absorption tests. Additionally, scanning electron microscopy (SEM), differential scanning calorimetry (DSC), and melt volume rate (MVR) measurements are conducted. To verify printing accuracy from a biomedical perspective, 3D‐printed prosthetic fingers are subjected to geometric assessments. Industrial PBF samples show significantly higher values for most mechanical properties, including a tensile Young's modulus of 1776 ± 19.42 MPa, while the second highest value is 1419 ± 58.77 MPa (MEX desktop). Furthermore, the MVR of the PBF industrial samples is the highest (18.34 cm3/10 min ± 2.32 cm3/10 min) and this printer exhibits superior performance in printing accuracy than the other printers. The balanced print quality and mechanics make the PBF industrial printer the most recommended for medical device production, but lower‐priced desktop FFF printers can be a good alternative for simple, fast solutions that do not require high precision.

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A study on the efficacy of AFO stiffness prescriptions

Cited by 14 publications

References 26 publications

Effects of Ankle Foot Orthoses on the Gait Patterns in Children with Spastic Bilateral Cerebral Palsy: A Scoping Review

Effects of Ankle Foot Orthoses on the Gait Patterns in Children with Spastic Bilateral Cerebral Palsy: A Scoping Review

A Review of Additive Manufacturing Studies for Producing Customized Ankle-Foot Orthoses

Comparative Analysis of Mechanical and Thermal Characteristics of 3D‐Printed Polyamide using Material Extrusion and Powder Bed Fusion Process with Industrial and Desktop Printers

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