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Understanding the mechanical properties of ankle-foot orthoses (AFOs) is important to maximize their benefit for those with movement disorders during gait. Though mechanical properties such as stiffness and/or energy efficiency of AFOs have been extensively studied, it remains unknown how and to what extent shoes influence their properties. The aim of this study was to investigate the effect of shoes on stiffness and energy efficiency of an AFO using a custom mechanical testing device. Stiffness and energy efficiency of the AFO were measured in the plantar flexion and dorsiflexion range, respectively, under AFO-alone and AFO-Shoe combination conditions. The results of this study demonstrated that the stiffness of the AFO-Shoe combination was significantly decreased compared to the AFO-alone condition, but no significant differences were found in energy efficiency. From the results, we recommend that shoes used with AFOs should be carefully selected not only based on their effect on alignment of the lower limb, but also their effects on overall mechanical properties of the AFO-Shoe combination. Further study is needed to clarify the effects of differences in shoe designs on AFO-Shoe combination mechanical properties.
Kobayashi is with the Department of Prosthetics and Orthotics, Faculty of Health Sciences, Hokkaido University of Science, Sapporo, Hokkaido, Japan. Kobayashi and Orendurff are with the Orthocare Innovations, Mountlake Terrace, WA. Gao is with the Department of Health Care Sciences, School of Health Professions, University of Texas Southwestern Medical Center, Dallas, TX. LeCursi is with the Becker Orthopedic, Troy, MI. Foreman is with the Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT. Orendurff is with the Motion & Sports Performance Laboratory, Lucile Packard Children’s Hospital, Stanford University, Palo Alto, CA.