Functional and perceptive differences between conventional and advanced ankle foot orthoses in community ambulators post-limb trauma: the injuries managed with advanced bracing of the lower extremity (IM ABLE) study.
M Jason Highsmith, Rebecca M Miro, Michael Kartel and 13 others
PMID 39011087WHAT IT FOUND
Advanced AFOs did not improve walking speed or distance compared to conventional ones, but users reported less effort and strongly preferred them for long-term use.
Key findings
01Objective mobility measures (Timed Up and Go and 2-Minute Walk Test) showed no significant difference between advanced and conventional AFOs.
02Users perceived significantly less exertion (lower Borg RPE) when using the advanced AFO during the walk test.
0380% of subjects preferred the advanced AFO for overall long-term use, with a statistically significant preference over conventional devices.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was interrupted by the COVID-19 pandemic, which limited recruitment and may have introduced self-selection bias. The sample was underpowered for physical performance measures, meaning small but real differences in mobility might have been missed. Participants had varying levels of prior experience with AFOs, and the accommodation period was short (up to 2 weeks), which may not reflect long-term adaptation. The population was heterogeneous, including neurologic and traumatic etiologies, making it difficult to isolate effects for specific conditions.
Declared interests
The study was funded by the US Department of Defense. The authors declared that the content represents their opinions and not necessarily those of the funding agencies or institutions.
The easy way to misread this
Do not assume the advanced AFO improves walking speed or distance. The study found no significant difference in these objective mobility measures, so the benefits are primarily perceptual (less effort) and related to user preference.