The Effects of AFO Heel Height and Stiffness on Gait

GROUP 1 Patient Inclusion criteria

• Ages: 18-70
• Daily AFO use to address unilateral, below knee functional deficits that result from limb injury or musculoskeletal disease (e.g. fracture, muscle and/or nerve injury, ankle arthritis)
• Greater than 2 weeks using their current AFO
• Ability to walk 50 feet without use of an assistive device (Cane, crutch, etc.)
• Ability to walk at a slow to moderate pace
• AFO fits into traditional footwear
• Able to read and write in English and provide written informed consent

GROUP 1 Patient Exclusion criteria

• Pain > 6/10 while walking during testing or an increase in pain during testing of > 2/10.
• Central Nervous System disorder or disease (e.g. Stroke, Cerebral Palsy, Spinal Cord Injury, or other conditions that result in lower limb spasticity).
• Disorder or disease that affects peripheral nerve function (e.g. diabetes, Charcot Marie Tooth).
• Limited contralateral lower limb function due to injury or neurological/musculoskeletal disorder.
• Use of a hinged/articulating AFO (e.g. Plantar flexion stop, Dorsiflexion assist/stop, free motion), Charcot Restraint Orthotic Walker (CROW) boot, AFOs that restrict all motion in the ankle and foot.
• Use of an AFO that crosses the knee (Knee brace)
• Insufficient space in shoe to accommodate the tallest heel wedge and their AFO
• Visual or hearing impairments that limit walking ability or could limit the ability to comply with instructions given during testing
• Pregnancy - Per participant self-report. Due the expected small number of pregnant individuals, and resulting inability to account for its effect on resulting outcomes participants will be withdrawn from the study.
• Body Mass index > 40.

GROUP 2 Patient Inclusion Criteria

• Ages: 18-70
• Daily AFO use to address below knee functional deficits that result from disease involving the peripheral nervous system (e.g. Charcot Marie Tooth, Multiple Sclerosis, diabetes)
• Greater than 2 weeks using their current AFO (unilateral or bilateral)
• Ability to walk 50 feet without use of an assistive device (Cane, crutch, etc.)
• AFO fits into traditional footwear
• Ability to walk at a slow to moderate pace
• Able to read and write in English and provide written informed consent

GROUP 2 Patient Exclusion Criteria

• Pain > 6/10 while walking or an increase in pain during testing of > 2/10
• Central Nervous System disorder or disease (e.g. Stroke, Cerebral Palsy, Spinal Cord Injury, or other conditions that result in lower limb spasticity)
• Limited function due to limb injury (e.g. fracture, muscle and/or nerve injury)
• Use of a hinged/articulating AFO (e.g. Plantar flexion stop, Dorsiflexion assist/stop, free motion), Charcot Restraint Orthotic Walker (CROW) boot, AFOs that restrict all motion in the ankle and foot.
• Use of an AFO that crosses the knee (Knee brace)
• Insufficient space in shoe to accommodate the tallest heel wedge and their AFO
• Visual or hearing impairment that limit walking ability or limit the ability to comply with instructions given during testing
• Pregnancy - Per participant self-report. Due the expected small number of pregnant individuals, and resulting inability to account for its effect on resulting outcomes participants will be withdrawn from the study
• Body Mass index > 40.