Stiffness and alignment of ankle-foot orthoses (AFOs) should be tuned optimally to maximize their function. Improperly tuned AFO may induce joint pain, reduced ambulatory function, and increased medical complications for patients with stroke. Therefore, the relative quality of AFOs fit determined by its stiffness and alignment is of paramount concern in the daily lives of patients ambulating with an AFO. However, no clinical tool is currently available that can objectively guide orthotists to tune the AFO. This has led frequent mismatches between the needs of the patient and the delivered orthosis. The objective of the proposed work is to develop a novel system for AFOs called the Computerized Orthotic Prescription System (COPS). COPS assists orthotists in tuning the AFO stiffness and alignment dynamically in patients with stroke. COPS consists of a diagnostic AFO, intuitive clinical software and a custom-made modular AFO. The diagnostic AFO and the clinical software are used to select optimal components for the custom-made modular AFO delivered to each patient. The diagnostic AFO allows fine- tuning of stiffness and alignment and monitors ankle joint moment and motion. The data will be wirelessly transferred to the computer and the clinical software will instruct how the stiffness and alignment of an AFO should be adjusted. Once the tuning of the diagnostic AFO is completed, the software recommends which components should be selected for the modular AFO. The COPS will give confidence to both orthotists and patients and also significantly reduce time for the iterative process of stiffness and alignment tuning of a AFO.

Public Health Relevance

This project will develop a system that can assist and improve the prescription of ankle-foot orthoses (AFOs) for patients with stroke. The technology will objectively guide the orthotists to determine the optimal stiffness and alignment of AFOs to maximize their dynamic function for each patient in an expedient and cost-effective manner.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Small Business Innovation Research Grants (SBIR) - Phase II (R44)
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Musculoskeletal Rehabilitation Sciences Study Section (MRS)
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Quatrano, Louis A
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Orthocare Innovations, LLC
Oklahoma City
United States
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Kobayashi, Toshiki; Orendurff, Michael S; Singer, Madeline L et al. (2016) Reduction of genu recurvatum through adjustment of plantarflexion resistance of an articulated ankle-foot orthosis in individuals post-stroke. Clin Biomech (Bristol, Avon) 35:81-5
Kobayashi, Toshiki; Singer, Madeline L; Orendurff, Michael S et al. (2015) The effect of changing plantarflexion resistive moment of an articulated ankle-foot orthosis on ankle and knee joint angles and moments while walking in patients post stroke. Clin Biomech (Bristol, Avon) 30:775-80
Singer, Madeline L; Kobayashi, Toshiki; Lincoln, Lucas S et al. (2014) The effect of ankle-foot orthosis plantarflexion stiffness on ankle and knee joint kinematics and kinetics during first and second rockers of gait in individuals with stroke. Clin Biomech (Bristol, Avon) 29:1077-80
Howell, Adam M; Kobayashi, Toshiki; Chou, Teri Rosenbaum et al. (2012) A laboratory insole for analysis of sensor placement to determine ground reaction force and ankle moment in patients with stroke. Conf Proc IEEE Eng Med Biol Soc 2012:6394-7