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.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Small Business Innovation Research Grants (SBIR) - Phase II (R44)
Project #
5R44HD069095-03
Application #
8554918
Study Section
Musculoskeletal Rehabilitation Sciences Study Section (MRS)
Program Officer
Quatrano, Louis A
Project Start
2011-09-28
Project End
2014-06-30
Budget Start
2013-07-01
Budget End
2014-06-30
Support Year
3
Fiscal Year
2013
Total Cost
$575,630
Indirect Cost
Name
Orthocare Innovations, LLC
Department
Type
DUNS #
801230413
City
Oklahoma City
State
OK
Country
United States
Zip Code
73104
Kobayashi, Toshiki; Orendurff, Michael S; Hunt, Grace et al. (2018) The effects of an articulated ankle-foot orthosis with resistance-adjustable joints on lower limb joint kinematics and kinetics during gait in individuals post-stroke. Clin Biomech (Bristol, Avon) 59:47-55
Kobayashi, Toshiki; Orendurff, Michael S; Singer, Madeline L et al. (2018) Effect of plantarflexion resistance of an ankle-foot orthosis on ankle and knee joint power during gait in individuals post-stroke. J Biomech 75:176-180
Kobayashi, Toshiki; Orendurff, Michael S; Singer, Madeline L et al. (2017) Contribution of ankle-foot orthosis moment in regulating ankle and knee motions during gait in individuals post-stroke. Clin Biomech (Bristol, Avon) 45:9-13
Kobayashi, Toshiki; Orendurff, Michael S; Hunt, Grace et al. (2017) An articulated ankle-foot orthosis with adjustable plantarflexion resistance, dorsiflexion resistance and alignment: A pilot study on mechanical properties and effects on stroke hemiparetic gait. Med Eng Phys 44:94-101
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