The effect of proximal cuff design on limb loading and mechanics during gait with carbon fiber custom dynamic orthoses, in unimpaired individuals.
Kirsten M Anderson, Wesley J Gari, Molly S Pacha and 1 others
PMID 42520742WHAT IT FOUND
Four different CDO cuff designs produced similar gait mechanics, foot loading, and comfort in 15 healthy adults.
Choose the cuff based on the patient's donning ability, ankle range of motion, and preference rather than expecting one design to offload the foot better.
Key findings
01No significant differences were found between the four cuff designs for gait mechanics, foot loading, or comfort scores.
02All four cuffs significantly reduced peak forefoot force and forefoot impulse, and significantly increased hindfoot impulse, compared to walking without an orthosis.
03All four cuffs significantly reduced ankle range of motion and peak ankle plantarflexion and dorsiflexion compared to walking without an orthosis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
All 15 participants were unimpaired; biomechanical responses and adaptation strategies in injured patients may differ, though the authors note the CDO effects align with prior work in injured populations. Cuff tightness was not standardised across participants or cuffs, so the impact of fastening force on foot loading is unknown. Participants were instructed to don the CDO with the foot resting on the footplate, which may have limited the offloading potential of the patellar tendon bearing cuffs. No targeted training programme was provided, which prior work suggests can further reduce forefoot loading. The sample of 15 is small, limiting the power to detect modest between-cuff differences.
Declared interests
The authors declared no conflicts of interest. No funding source is stated in the text provided.
The easy way to misread this
Do not assume a patellar tendon bearing cuff will offload the hindfoot more than a generic cuff, or that a ratcheting closure will reduce forefoot loading more than straps. No significant differences were found between any of the four cuffs. Also note the study enrolled 15 healthy adults with no limb trauma, so the findings may not generalise to the injured patients you treat.