Predicting Clinical Outcomes Using a Physical Platform to Simulate Orthoses with Different Characteristics
Abstract
For patients with lower leg weakness and stiffness, or those who have difficulty controlling their lower legs, ankle-foot orthoses (AFOs) are an important tool used by clinicians to help improve walking ability and balance. Most AFOs contain few moving parts but come in several different designs, each one with slightly different properties. Selecting the appropriate AFO is a time-consuming process that can involve multiple visits to an orthotist. Much of the success of an AFO depends on the experience of the orthotist, who uses the way a patient walks, their weight, and activity level to select the desired AFO configuration. Even for an experienced orthotist, choosing the optimal AFO settings and predicting how well a patient will do with the selected AFO is challenging. With the introduction of new motorized AFOs that have more options to be configured, it is more important than ever to define precise and accurate methods to determine the ideal AFO parameters for a given patient. The purpose of this project is to develop ways to improve the selection of AFO characteristics that are optimized for each individual. We propose to use the platform (ExoBoot) developed by Dephy, Inc. as a means to simulate different AFOs and their characteristics in order to assess which AFO design is best suited for a given patient. This project has the potential to benefit a number of patient populations that suffer from lower limb weakness and stiffness including stroke, spinal cord, traumatic brain injury, and lower limb trauma. Those affected are not limited to civilians but also affect Veterans and active Service members to varying degrees. These populations are common users of AFOs and many are using AFOs that are not completely optimal for their specific combination of impairments. The platform used in this study, as well as the knowledge gained from this project, has the potential to inform the creation of clinical guidelines for AFO prescription over the next few years. Evidence-based clinical guidelines can lead to improved clinical outcomes as well as provide insight that will be useful for future AFO and platform development. In the long term, we foresee the availability of devices and platforms that can automatically determine the physical needs of an individual and provide user optimized assistance to improve clinical outcomes.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010261
Entities
People
- Paolo Bonato
Organizations
- Spaulding Rehabilitation Hospital
- United States Army