Ankle-foot orthosis mechanical testing: a scoping review.
Katherine Vaiciulis, Zachary Williston, Deema Totah
PMID 42380911WHAT IT FOUND
Different tests of ankle-foot orthosis stiffness can disagree, so measured stiffness may not mean the same thing across labs.
Clinicians cannot yet rely on stiffness numbers to choose an AFO until testing methods are standardized.
Key findings
01The review included 46 papers on AFO stiffness testing and created a taxonomy to classify their design and operation.
02The paper reports a median relative percent difference of 62% in measured AFO stiffness between testing methods, and 27% when the static method was excluded.
03Most AFO stiffness tests flex the orthosis only in the sagittal plane, and only five methods deflect it in multiple planes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a scoping review of testing methods, not a clinical trial or patient outcome review. It does not show whether measuring AFO stiffness improves walking, falls, or function. The included papers vary in what they report, and some did not report flexion speed or other parameters. The authors say their mechanical engineering background may affect how they interpreted the literature. There is no accepted reference stiffness value to validate methods against. Most methods only test one plane of motion, so they may miss frontal or transverse forces relevant to some AFOs. The review did not include unpublished work, which may exist in clinical settings.
The easy way to misread this
Do not conclude that AFO stiffness measurement is ready for routine clinical prescription decisions. The review maps testing methods and shows they are not standardized. It does not prove that choosing an AFO by measured stiffness improves gait or falls.