State of the Prescription Process for Dynamic Ankle-Foot Orthoses

Purpose of Review: Dynamic ankle-foot orthoses (AFOs) are assistive devices that can be prescribed to individuals with mobility limitations to support and align joints. Dynamic AFOs are a category of passive AFOs that can control ankle motion to address both ankle joint range of motion limitations and ankle muscle weakness. This control of motion is achieved through the dynamic AFO’s functional characteristics, namely bending stiffness, which need to be customized to each individual’s needs. However, current conventions for customizing dynamic AFOs for each individual are variable and often not clearly documented. The purpose of this review was to synthesize the current state of customizing functional characteristics of dynamic AFOs to provide a foundation for ultimately optimizing the prescription of AFOs. Recent Findings: Dynamic AFO bending stiffness, bending axis, alignment, and footplate design were identified as key functional characteristics that can be customized. Studies showed that customizing these dynamic AFO functional characteristics has the ability to alter gait, and customizing multiple functional characteristics at once is key to improving individual outcomes. Summary: Researchers have continued to expand their knowledge on how dynamic AFO functional characteristics can impact individual outcomes. Continued research should work towards developing guidelines for prescribing dynamic AFO functional characteristics based on individuals’ level of needs. Additionally, researchers and clinicians need to work together to ultimately translate these scientific findings into clinical practice. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.