Below-knee orthosis: a wrap-around design for ankle-foot control

Area of Science:

• Orthotics and Biomechanics
• Pediatric Rehabilitation
• Neuromuscular Disorders

Background:

• Controlling foot and ankle position in children with spastic paralytic disorders presents significant challenges compared to flaccid disorders.
• Existing orthotic appliances often fall short in providing adequate support and control for these complex conditions.

Purpose of the Study:

• To introduce and evaluate a novel custom-molded plastic ankle-foot orthosis (AFO) designed for improved efficacy in pediatric patients.
• To assess the AFO's effectiveness in providing rigid limb control and potentially inhibiting abnormal motor tone.

Main Methods:

• The AFO is custom vacuum-molded from thin polypropylene, lined with Aliplast foam, and features a complete limb enclosure with an anterior opening and Velcro straps.
• The design utilizes circumferential support to achieve rigidity despite the pliable material.

Main Results:

• The new AFO design demonstrated superior performance across various applications, particularly in managing spastic paralytic disorders.
• Successful application was noted in children with polio, meningomyelocele, and various forms of cerebral palsy (spastic and athetoid).
• Patients reported increased comfort compared to previously worn orthoses, and a potential benefit of reflex inhibition of abnormal motor tone was observed in spastic patients.

Conclusions:

• The custom-molded polypropylene AFO provides superior circumferential support and rigid control for pediatric patients with neuromuscular disorders.
• The design offers enhanced comfort and potential therapeutic benefits, including reflex inhibition, making it a preferred option for managing complex lower limb conditions.