Credit Hours
1.75 Scientific Credits
Learning Objectives
Please see course description.
Course Description
Free Papers: Lower Limb Orthoses - Mechanical Design and Biomechanics (AM2025-FP09)
Repeatability of a Novel In-Vivo Strain Measurement Approach in Carbon Fiber Custom Dynamic Orthoses
Presenter: Sara M. Magdziarz, BSE – Graduate Research Assistant, University of Iowa
Current approaches to assess mechanical properties of ankle foot orthoses (AFOs) largely ignore potential effects of the limb-orthosis interaction. 30 healthy individuals wore a carbon fiber orthosis that was tracked using a digital image correlation (DIC) system as the participant deflected the strut of the AFO at three different time points: after brief accommodation, after repositioning the limb in the camera volume, and after doffing and re-donning the device. Measured strain was comparable to previously studied orthotic research. ICC values were better with more dorsiflexion or a more distal strut location, and MDC values as a percentage of mean values were ≤0.15% for all time points.
Learning Objectives:
- Upon completion, participants will be able to describe potential advantages of using digital image correlation systems over traditional AFO mechanical testing methods.
- Upon completion, participants will be able to describe the effect of measurement location and deflection angle on strain of a carbon fiber orthosis.
- Upon completion, participants will be able to indicate when the use of digital image correlation is applicable for the assessment of strain.
Effect of Carbon Fiber Custom Dynamic Orthosis Stiffness on Limb Mechanics During Gait
Presenter: Kirsten M. Anderson, BSE – Graduate Research Assistant, University of Iowa
The design of carbon fiber custom dynamic orthoses (CDOs) can be selected to meet patient needs. However, the effect of CDO stiffness on foot loading has not been previously studied. Participants who had sustained an intra-articular ankle fracture within five years were tested without an orthosis and with compliant, moderate, and stiff CDOs. Only minor differences in mechanics and foot loading were seen across CDO stiffnesses, despite the Stiff CDO being nearly 80% stiffer than the Compliant CDO.
Learning Objectives:
- Upon completion, participants will be able to describe available literature related to the effect of orthosis stiffness on gait.
- Upon completion, participants will be able to describe the effect of carbon fiber custom dynamic orthosis stiffness on ankle mechanics.
- Upon completion, participants will be able to describe the effect of carbon fiber custom dynamic orthosis stiffness on foot loading.
Effect of Carbon Fiber Custom Dynamic Orthosis Use on Limb Mechanics Following Traumatic Lower Limb Injury
Presenter: Jason M. Wilken, PT, PhD – Associate Professor, University of Iowa
The effect of commercially available carbon fiber custom dynamic orthosis (CDO) design on gait mechanics is not well studied. 23 individuals who experienced traumatic lower limb injury underwent computerized gait analysis while wearing modular and monolithic CDOs. Study CDOs significantly reduced ankle ROM and push-off power compared to NoCDO, without significant differences between designs. However, push-off power was more than 25% greater than previously reported with other CDOs.
Learning Objectives:
- Upon completion, participants will be able to describe the role of carbon fiber custom dynamic orthoses in restoring limb mechanics after traumatic injury.
- Upon completion, participants will be able to describe the effect of orthosis design on limb mechanics.
- Upon completion, participants will be able to compare and contrast the effects of commercially available carbon fiber custom dynamic orthoses with the findings of previous literature.
An Adjustable Dynamic AFO - Dorsiflexion Angle at Different Strut Stiffness Settings During Running
Presenter: Joan E. Sanders, PhD – Professor, University of Washington
An innovative instrumented adjustable dynamic ankle-foot orthosis is described. The technology monitors AFO torque and angle and may have use as a diagnostic and fitting tool in clinical care. Results from able-bodied participants running at different strut stiffness settings are presented and discussed.
Learning Objectives:
- Describe how dynamic AFO strut stiffness changes affect measured torque and ankle angle metrics during running
- Describe how a participant’s muscular action can contribute to the performance of the AFO.
- Describe a novel adjustable stiffness strut that is operated without removing the dynamic AFO, and explain how it may be used in clinical and research applications
Systematic Review and Meta-analysis of Foot Orthosis Biomechanics in Runners with Asymptomatic Flatfeet
Presenter: Abu Jor, M.Sc. – Ph.D. Student, The Hong Kong Polytechnic University
Although most asymptomatic flatfeet are considered anatomical variants, this condition is typically associated with pronation, which may alter multiple joint motions of the foot, including dorsiflexion, eversion, and abduction. Using arch-support foot orthoses with medial posts could be effective in reducing pronation-related musculoskeletal disorders in runners with asymptomatic flatfeet.
Learning Objectives:
- Upon completion, the participant will be able to get a comprehensive idea of the benefits of using FOs during running in individuals with asymptomatic flatfeet.
- Upon completion, the participant will be able to understand the mechanisms by which medial posts in FOs could modify lower extremity biomechanics.
- Upon completion, the participant will be able to identify the gap in FOs research to facilitate runners.
The Effects of Carbon Fiber Custom Dynamic Orthosis Proximal Cuff Design on Foot Loading During Gait
Presenter: Kirsten M. Anderson, BSE – Graduate Research Assistant, University of Iowa
The design of carbon fiber custom dynamic orthoses (CDOs) can be selected to meet patient needs. However, the effect of CDO proximal cuff design on foot loading has not been previously studied. Participants were tested without an orthosis and with three commonly used proximal cuff designs. Average peak forefoot and hindfoot forces decreased by over 22% and 11% with CDO use, respectively. Moderate to large effect sizes indicate that CDO cuff design may influence peak foot loading.
Learning Objectives:
- Upon completion, participants will be able to describe available literature related to the use of orthoses for foot offloading.
- Upon completion, participants will be able to describe the effect of CDO use on foot loading.
- Upon completion, participants will be able to describe the effect of orthosis cuff design on foot loading.
Event Presenter(s)
Presenter Name(s)
- Sara M. Magdziarz, BSE
- Kirsten M. Anderson, BSE
- Jason M. Wilken, PT, PhD
- Joan E. Sanders, PhD
- Abu Jor, M.Sc.
- Curt Bertram, CPO, FAAOP
Disclaimer
The user acknowledges that the workshops, handouts, and related course materials contained therein are intended for educational purposes only, and should not be considered to be legal advice or a substitute for legal or clinical consultation. These presentations address issues that are multi-faceted, and the user should not assume that the courses discuss every law, regulation, or ethical code that may be relevant to the subject matter. Legal and ethical standards are subject to change and it is always prudent to check to see whether a particular law, regulation, or ethical standard may have changed.
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