Abstract

This study details the concept, design, and mechanical testing results of a novel dual-stiffness ankle-foot orthosis (DS-AFO). The DS-AFO utilizes two separate stiffness elements (rear struts) to yield an AFO with low stiffness properties about the ankle in the sagittal plane at small dorsiflexion angles, and higher stiffness at larger dorsiflexion angles. The motivation behind this DS-AFO follows from the existence of similar moment-angle (stiffness) properties of the healthy human ankle during walking, referred to as dual-stiffness natural ankle quasi-stiffness (DS-NAS). Crucial to the design of the DS-AFO is the ability to adjust both the stiffness and the dorsiflexion angle at which the net stiffness increases, referred to as the activation angle. Three different DS-AFO stiffness configurations were tested, each with three different activation angles, along with a standard single strut/stiffness AFO configuration. The DS-AFO was able to achieve distinct regions of low and high stiffness at every configuration. Additionally, altering the activation angle by ±1 deg generally did not result in different stiffness properties. This work is a step forward in AFOs with complex stiffness properties that can better approximate the mechanics of a healthy human ankle.

References

1.
Koller
,
C.
, and
Arch
,
E. S.
,
2018
, “
State of the Prescription Process for Dynamic Ankle-Foot Orthoses
,”
Curr. Phys. Med. Rehabil. Rep.
,
6
, pp. 55–61.10.1007/s40141-018-0177-x
2.
Faustini
,
M. C.
,
Neptune
,
R. R.
,
Crawford
,
R. H.
, and
Stanhope
,
S. J.
,
2008
, “
Manufacture of Passive Dynamic Ankle – Foot Orthoses Using Selective Laser Sintering
,”
IEEE Trans. Biomed. Eng.
,
55
(
2
), pp.
784
790
.10.1109/TBME.2007.912638
3.
Nolan
,
K. J.
, and
Yarossi
,
M.
,
2011
, “
Clinical Biomechanics Preservation of the First Rocker is Related to Increases in Gait Speed in Individuals With Hemiplegia and AFO
,”
JCLB
,
26
(
6
), pp.
655
660
.10.1016/j.clinbiomech.2011.03.011
4.
Harper
,
N. G.
,
Russell
,
E.
,
Wilken
,
J. M.
, and
Neptune
,
R. R.
,
2014
, “
The Influence of Ankle-Foot Orthosis Stiffness on Walking Performance in Individuals With Lower-Limb Impairments
,”
JCLB
,
29
(
8
), pp.
877
884
.10.1016/j.clinbiomech.2014.07.005
5.
Esposito
,
E. R.
,
Blanck
,
R. V.
,
Harper
,
N. G.
,
Hsu
,
J. R.
, and
Wilken
,
J. M.
,
2014
, “
How Does Ankle-Foot Orthosis Stiffness Affect Gait in Patients With Lower Limb Salvage?
,”
Clin. Orthop. Relat. Res.
,
472
(
10
), pp.
3026
3035
.10.1007/s11999-014-3661-3
6.
Arch
,
E. S.
, and
Reisman
,
D. S.
,
2016
, “
Passive-Dynamic Ankle-Foot Orthoses With Personalized Bending Stiffness Can Enhance Net Plantarflexor Function for Individuals Poststroke
,”
J. Prosthet. Orthot.
,
28
(
2
), pp.
60
67
.10.1097/JPO.0000000000000089
7.
Davis
,
R. B.
, and
Deluca
,
P. A.
,
1996
, “
Gait Characterization Via Dynamic Joint Stiffness
,”
Gait Posture
,
4
(
3
), pp.
224
231
.10.1016/0966-6362(95)01045-9
8.
Nigro
,
L.
, and
Arch
,
E.
,
2022
, “
Comparison of Existing Methods for Characterizing Bi-Linear Natural Ankle Quasi-Stiffness
,”
ASME J. Biomech. Eng.
,
144
(
11
), p.
114502
.10.1115/1.4054798
9.
Shamaei
,
K.
,
Sawicki
,
G. S.
, and
Dollar
,
A. M.
,
2013
, “
Estimation of Quasi-Stiffness and Propulsive Work of the Human Ankle in the Stance Phase of Walking
,”
PLoS One
,
8
(
3
), p.
e59935
.10.1371/journal.pone.0059935
10.
Crenna
,
P.
, and
Frigo
,
C.
,
2011
, “
Dynamics of the Ankle Joint Analyzed Through Moment-Angle Loops During Human Walking: Gender and Age Effects
,”
Hum. Mov. Sci.
, 30(6), pp.
1185
1198
.10.1016/j.humov.2011.02.009
11.
Hansen
,
A. H.
,
Childress
,
D. S.
,
Miff
,
S. C.
,
Gard
,
S. A.
, and
Mesplay
,
K. P.
,
2004
, “
The Human Ankle During Walking: Implications for Design of Biomimetic Ankle Prostheses
,”
J. Biomech.
,
37
(
10
), pp.
1467
1474
.10.1016/j.jbiomech.2004.01.017
12.
Perry
,
J.
,
1992
,
Gait Analysis: Normal and Pathological Function
, 2nd ed.,
Slack, Inc.
,
Thorofare, NJ
.
13.
Mueller
,
M. J.
,
Minor
,
S. D.
,
Schaaf
,
J. A.
,
Strube
,
M. J.
, and
Sahrmann
,
S. A.
,
1995
, “
Relationship of Plantar-Flexor Peak Torque and Dorsiflexion Range of Motion to Kinetic Variables During Walking
,”
Phys. Ther.
,
75
(
8
), pp.
684
693
.10.1093/ptj/75.8.684
14.
Bregman
,
D. J. J.
,
Rozumalski
,
A.
,
Koops
,
D.
,
De Groot
,
V.
,
Schwartz
,
M.
, and
Harlaar
,
J.
,
2009
, “
A New Method for Evaluating Ankle Foot Orthosis Characteristics: BRUCE
,”
Gait Posture
,
30
(
2
), pp.
144
149
.10.1016/j.gaitpost.2009.05.012
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