Identifying the Optimal Patient-Specific Dynamic Ankle-Foot Orthosis Bending Stiffness in an Evidence-Based Manner That Can Be Implemented by Clinical Providers
Abstract
Spring-like ankle braces are a special type of ankle brace that can partially replicate, and replace, the function of ankle muscles that has been lost due to injury or disease. In the past decade, the rate of development and clinical prescription of these spring-like ankle braces has dramatically increased. Initially, development and prescription of these spring-like ankle braces was targeted for high-functioning individuals, such as Wounded Warriors with limb salvage. In recent years, however, the prescription of these ankle braces for other patient populations, including individuals who have suffered a stroke, has begun to substantially increase as the field recognizes the efficacy of these ankle braces for a range of populations. Stroke is the leading cause of disability in the United States and one of the leading causes of disability in Veterans. Ankle muscle weakness is a common impairment in individuals who have sustained a stroke and often results in reduced walking ability. This reduced walking ability has debilitating long-term health consequences. Current rehabilitation strategies do not sufficiently improve the factors that limit walking ability after a stroke, suggesting a need for new and innovative approaches, such as new approaches for prescribing the optimal ankle brace for each patient. To optimize a patient’s outcomes, such as an individual’s walking ability, the characteristics of these spring-link ankle braces likely need to be matched to each individual patient’s needs. However, despite increasing prescription of these spring-like ankle braces, little information exists to guide providers as to how to optimally select the ankle brace characteristics to meet each patient’s needs. Currently, the prescription process for ankle braces requires trial and error, often over numerous clinical visits, which results in highly variable and often suboptimal patient outcomes. Thus, the overall objective of this study is to identify the influence of different levels of assistance provided by a spring-like ankle brace on walking function and mobility for individuals who have suffered a stroke and provide evidence to guide providers in identifying this optimal level of assistance for each patient. This study will take place over a 3-year period and include 40 individuals who have sustained a stroke. During the study, participants will have measurements (outcomes) taken in the laboratory while they walk while wearing a spring-like ankle brace that provides five different levels of assistance. These measurements will include how well they walk, how quickly they walk, their mobility and balance, and their satisfaction with the ankle brace. We expect that participants will walk and function differently with different levels of assistance provided by the ankle brace, and we expect that they will walk and function the best with one of the ankle braces. Finally, we expect to be able to identify a candidate set of outcome measures that are related to how the participants function in the ankle brace with varying level of assistance. The risks associated with this study are small, such as experiencing mild skin irritation from the ankle brace or a minor fall during the walking tests. These risks are no more than an individual would incur during their typical activities of daily living, and precautions will be taken to minimize the risks, including adjusting fit of the ankle brace if the participant experiences discomfort or skin irritation and having the participants wear a safety harness during the walking tests in the laboratory. Moreover, the potential benefits of this study outweigh the risks. This study will provide evidence to guide orthotists (those who prescribe ankle braces) as to how to optimally select the level of assistance that the spring-like ankle brace provides for any given patient. Improving the prescription of ankle braces, as will be done through this study, will help individuals who have suffered a
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310106
Entities
People
- Elisa Arch
Organizations
- United States Army
- University of Delaware