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Cli­ni­cal eva­lua­ti­on of dif­fe­rent ank­le joint stiff­nes­ses – A modu­lar test­ing ortho­sis as a tool for cus­to­mi­zed AFO treatment

Christina Krieger1, Ole Strenge2, Carsten Dilthey3, Juliane Wühr4, David Hochmann2, Carsten Kramer1, Ulrich Hafkemeyer5
This article describes the development and testing of a modular testing orthosis as a tool for everyday clinical practice. The orthosis allows for variation in stiffness around the ankle joint and the metatarsophalangeal joints, as well as adjustment of the neutral angle at the ankle joint. It is intended to serve as a tool for selecting orthotic configurations that best meet the individual treatment goals of patients. In an initial study, the orthosis was tested on a subject with lower-limb-predominant spastic hemiparesis and a retrograde gait pattern. The fundamental applicability of the concept in routine clinical practice was confirmed. The results form the basis for further research on objective decision-making and the application of the findings to definitive treatments.
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Fig. 1a & b General concept of the testing orthosis: smallest and largest configurations of the testing orthosis (a), components of the testing orthosis in one size configuration (b).
General concept of the testing orthosis: smallest and largest configurations of the testing orthosis (a), components of the testing orthosis in one size configuration (b).

Chris­ti­na Krieger1, Ole Strenge2, Cars­ten Dilthey3, Julia­ne Wühr4, David Hochmann2, Cars­ten Kramer1, Ulrich Hafkemeyer5
This artic­le descri­bes the deve­lo­p­ment and test­ing of a modu­lar test­ing ortho­sis as a tool for ever­y­day cli­ni­cal prac­ti­ce. The ortho­sis allows for varia­ti­on in stiff­ness around the ank­le joint and the meta­tar­so­phal­an­ge­al joints, as well as adjus­t­ment of the neu­tral ang­le at the ank­le joint. It is inten­ded to ser­ve as a tool for sel­ec­ting ortho­tic con­fi­gu­ra­ti­ons that best meet the indi­vi­du­al tre­at­ment goals of pati­ents. In an initi­al stu­dy, the ortho­sis was tes­ted on a sub­ject with lower-limb-pre­do­mi­nant spas­tic hemi­pa­re­sis and a retro­gra­de gait pat­tern. The fun­da­men­tal appli­ca­bi­li­ty of the con­cept in rou­ti­ne cli­ni­cal prac­ti­ce was con­firm­ed. The results form the basis for fur­ther rese­arch on objec­ti­ve decis­i­on-making and the appli­ca­ti­on of the fin­dings to defi­ni­ti­ve treatments.

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