Ankle-Foot Orthoses (AFOs) present a promising alternative to crutches for enabling ambulation in medical conditions requiring foot or ankle offloading. In our recent study, we compared the effects of three unloading devices (forearm crutches, a knee crutch, and a prefabricated AFO) on various gait parameters (Saffuri et al., 2024). While the AFO demonstrated more favorable gait performance than the other devices, it also revealed significant limitations.

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To address these issues, we have developed and evaluated a novel adjustable-loading AFO that incorporates several innovative features. First, the orthosis includes a patient-specific shank brace, designed from a 3D scan, to improve load distribution across the shank’s soft tissues and enhance wearer comfort. Second, an adjustable load mechanism allows precise control over the offloading level, between 0-100% foot loading, by varying the brace height. Third, the design integrates contact plates that support the foot medially and laterally. These plates feature a Roll-Over Shape (ROS), which is computed by mapping the center of pressure onto a shank-fixed coordinate system. This approach is intended to promote a more natural and symmetrical gait, even during complete offloading.

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The anticipated benefits of this device include mitigating adverse effects associated with prolonged leg immobilization, such as muscle atrophy and bone density reduction in the affected leg, and secondary injuries due to overstraining the contralateral leg and upper body. The device is also expected to improve and shorten recovery through precise adjustment of partial loading.

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