Design And Testing Of Patient-Specific Ankle Foot Orthosis
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Date
2022-07-15
Authors
Md Sukri, Muhammad Ahnaf Ataulah
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Abnormal gait is a common foot deformity where the patient is unable to move
his forefoot during stance and walking position due to involuntary plantarflexion. An
ankle-foot orthosis is a medical device worn to assist the daily mobility of patients
suffering from ankle-foot deformity because of stroke or accident. However, the
available product in the market was costly, and the design was not suitable for local
patients due to the hot and humid tropical climate. The currently available product also
does not fit perfectly to a specific patient’s foot profile, resulting in discomfort and
therefore less usage by the patient. In this research, two types of Ankle Foot Orthosis
(AFO) devices have been successfully developed. Two AFO models, which are Type
1 (Hybrid AFO) and Type 2 (Hinged AFO) were fabricated by using Creality Ender 5
machine utilising 3D printing and 3D scanning technologies. Apart from that, two
other models Type 3 and Type 4, from previous work by Yong Shien also have been
taken for gait analysis purposes which is the main interest in this research. The gait
analysis is conducted as a pilot clinical study of the AFO performance in the
rehabilitation process in Hospital USM. In the study, two patients have been tested
with the devices to evaluate the performance of each AFO. It is found that the use of
any AFO devices can improve a patient’s gait deformity during the rehabilitation
program. The result shows that Type 2 (Hinged AFO) improved gait cycle time [CI =
95%; Without AFO vs. With AFO; 3.58 ± 0.18 vs. 2.92 ± 0.21 s; p = 0.0302] for active
patients, while there is no significant difference between the effectiveness of the
Hinged AFO in enhancing the gait performance of a passive patient during the
rehabilitation therapy (CI = 95%; Without AFO vs. With AFO; 4.05 ± 0.49 vs. 4.07 ±
0.63; p = 0.32). This, suggests that in the case of an active patient, both types of AFO
are suitable and produce a significant improvement, while solid AFO is more suitable
to improve the gait parameters for the passive patient with a significant difference of
(p = 0.025). A further clinical trial will be required to further investigate the efficacy
of the devices to sub-acute stroke patients in developing a fully functional ankle foot
orthosis for lower limb rehabilitation therapy.