Improving Walking with Custom-Tuned Ankle-Foot Orthoses for Adults with Lower Leg Muscle Weakness

What this Trial Is About

Researchers are investigating how customizing the stiffness of ankle-foot orthoses AFOs separately for upward and downward foot movements affects walking in people with neuromuscular disorders causing weakness in the lower leg muscles. This pilot study compares a new spring-hinged AFO with adjustable stiffness in both directions to three types of standard spring-like AFOs that have the same stiffness in both directions. The goal is to understand how these devices influence walking biomechanics, energy use, speed, and balance. Participants will receive a custom-made spring-hinged AFO featuring the NEURO SWING4 system ankle joint. The stiffness will be optimized individually using a special algorithm based on six different stiffness configurations tested after delivery. Participants will then use this optimized AFO at home for six weeks. At baseline, they will also be tested with three prefabricated spring-like AFOs of varying stiffness and their own AFO if they have one, as well as walking with shoes only. During the study, researchers will assess walking using 3D gait analysis to measure ankle and knee angles and velocities, along with walking energy cost, speed, standing balance, and participants perceptions of physical function and walking ability. Measurements will be taken immediately after fitting the optimized AFO and again after six weeks of use. This comprehensive evaluation aims to clarify how individualized AFO stiffness affects mobility and daily functioning in people with lower leg muscle weakness.

Bidirectional Tuning of the AFO Stiffness