Dynamic Ankle Foot Research Articles

Impact of plantar flexion resistive moment of dynamic ankle foot orthosis on measures of center of pressure and clinical gait outcomes in individuals with post-stroke hemiparesis

BackgroundAn ankle-foot orthosis (AFO) with plantar flexion resistance (PFR) can improve the first rocker function during gait, but the incremental changes in the resistive moment on balance and gait have not been well identified. ObjectivesTo investigate the effect of changing the PFR moment of dynamic AFO (DAFO) on measures of the center of pressure (COP) and clinical gait outcomes in individuals with post-stroke hemiparesis. MethodIn this randomized repeated measure study of 36 stroke individuals, the customized DAFO using foot drop ankle units set in three PFR situations (low, medium, and high) was evaluated. The balance parameters for COP measures were investigated by HUMAC® Balance & Tilt System. Gait parameters and ankle kinematics were recorded using the 3D motion analysis through force platform and optoelectronic system. The comparison was made using a parametric ANOVA test and the P value was set at 0.05 for statistical significance. ResultsSignificant differences were observed for COP average velocity (1.30 ± 0.64, 1.10 ± 0.05, and 1.37 ± 0.43), COP path length (43.3 ± 4.6, 33.4 ± 4.3, and 36.3 ± 5.4), walking velocity (11.0 ± 3.1, 13.2 ± 4.4, and 9.9 ± 3.5), and cadence (31.5 ± 2.0, 33.0 ± 3.1, and 29.0 ± 1.6) respectively for low, medium and high PFR settings (P < 0.05). Except for the COP path length and cadence, posthoc multiple comparisons revealed significant differences between low and medium (P < 0.05) and medium and high (P < 0.05) PFR grades. PFR with medium resistance demonstrated near-normal maximal peak ankle dorsiflexion (mean deviation of 8 degrees, P < 0.05). ConclusionMedium PFR grade should be encouraged since it can enhance balance parameters like path length and average velocity of COP, increase cadence and average velocity during gait, and improve maximal peak ankle dorsiflexion.

Assessment of Five-Foot Plantar Morphological Pressure Points of Children with Cerebral Palsy Using or Not Dynamic Ankle Foot Orthosis.

People with spastic cerebral palsy (CP) often experience a decline in gait function and flexion. The children's posture and hip strategy, which leads to knee flexion, predisposes these children to increased contact area in the medial foot region. This study investigated the use of DAFO (dynamic ankle-foot orthosis) prescribed to patients with cerebral palsy (CP) to determine the plantar pressure distribution with orthosis use. Eight children with spastic CP (age 4-12 years) were classified as Gross Motor Function Classification System (GMFCS) levels I-II with a maximum spasticity level of 3 in their ankle muscles according to the Modified Ashworth Scale. We assessed the plantar distribution by using eight WalkinSense sensors in each trial and exported data from the proprietary software (WalkinSense version 0.96, Tomorrow Options Microelectronics, S.A.). The plantar pressure distribution was conducted under two conditions: only shoes and DAFO with shoes. The activation percentages for sensor number 1 under the 1st metatarsal and sensor number 4 under the lateral edge of the heel were significantly different under the DAFO condition. The 1-point sensor activation percentage significantly decreased, while the 4-point sensor activation percentage increased during DAFO walking. According to our study findings, there was an increase in pressure distribution in the lateral part of the foot during the stance phase in DAFO. DAFO improved the gait cycle and influenced the plantar foot pressure in children with mild cerebral palsy.

Passive Dynamic Ankle Foot Orthoses Use in Civilian Patients with Arthritic Conditions of the Foot and Ankle.

Nonsurgical interventions such as bracing with ankle foot orthoses (AFOs) aim to assist, restore, and redirect weightbearing forces to address difficulty with mobilization. We identified a custom carbon fiber passive dynamic ankle foot orthosis (PDAFO) that was designed to meet the needs of military combat veterans. We sought to evaluate the off-loading properties of one model of PDAFO (ExoSym) in a civilian population. Civilian patients 18 years or older were prescribed a PDAFO by a single surgeon. Pedobarographic data were obtained using the Tekscan F-Scan system. With the insole, participants were instructed to walk at a self-selected pace along a 20 m walkway under 3 conditions: (1) insole placed in between the brace and foot (over); (2) insole placed between the brace and insole of the shoe (under); (3) without the brace, the insole was placed in between the foot and insole of the shoe in both limbs (without).For assessment, forefoot and heel areas were evaluated with respect to maximal force, force*time integral (FTI), maximal contact area, maximal contact pressure, pressure*time integral (PTI), center of force (COF) excursion. Six patients with arthritic foot and ankle conditions completed pedobarographic assessment for analysis. The brace reduced forefoot maximal force and contact pressures by 66% and 49%, respectively (538 ± 236 to 185 ± 130 N [P < .001], and 99 ± 38 to 50 ± 24 P < .002). Additionally, participants were observed to load the forefoot portion of the brace with double the maximum contact pressures compared to the unbraced foot (204 ± 57 to 99 ± 38 kPa, P < .001). The results of this study showed that the PDAFO unloaded substantial force and pressure experienced by the forefoot. Participants loaded the brace to a greater extent than when going unbraced. ADAFO can provide measurable pressure relief for patients with arthritic conditions. Level IV, case series.

A modified passive-dynamic ankle-foot orthosis: can it prevent amputation and arthrodesis in patients with ankle-foot trauma?

High-energy lower extremity trauma (HELET) may cause severe damage within the foot-ankle complex. Occasionally, arthrodesis or amputation are the only remaining options to increase activity levels. The modified passive dynamic ankle-foot orthosis (PDAFO) may prove to be a nonsurgical alternative. This study evaluated the effect of a modified PDAFO with a 6-week training program on pain and performance in patients after HELET. A retrospective cohort study was conducted on seventeen patients who considered an arthrodesis or an amputation after HELET. In an attempt to avoid surgery, the modified PDAFO with a 6-week training program was provided. Pain scores was measured with the Numeric Rating Scale and administered at the start of testing, immediately after the two performance tests and at the end of the day of testing. Performance was evaluated with the 6-min walk test (6MWT) and the Comprehensive high-level activity mobility predictor (CHAMP). A significant pain reduction was achieved after the treatment procedure. At the start of the test days (p = 0.002), after the 6MWT (p = 0.001), after the CHAMP (p < 0.001) and at the end of the day (p < 0.001). In addition, a significant improvement on performance was observed in the 6MWT (p < 0.001) and the CHAMP (p = 0.01). None of the patients considered a surgical intervention anymore. Patients after HELET show a decrease in pain and an improvement in performance after a 6-week training program with modified PD-AFO. The results suggest that the modified PDAFO is an effective alternative for a surgical approach.

645 Adjustable Dynamic Ankle Foot Orthosis for Recovery of Functional Mobility

Abstract Introduction We present a case of a 23-year-old woman with primary-onset peroneal nerve impairment following diagnosis of purpura fulminans involving 30% total body surface area, who was treated in our burn center. Medical complexity required a unique rehabilitation intervention. The purpose of this case study is to demonstrate the effectiveness of a dynamic ankle-foot orthosis (AFO) to recover functional ambulation. Methods Upon initial evaluation and during weekly re-evaluations, a physical therapist (PT) and an occupational therapist (OT) measured active range of motion (AROM), passive range of motion (PROM), and strength. Absent to trace common peroneal nerve function was identified bilaterally 8 days after admission. The patient underwent 41 surgeries and spent 231 days in the burn intensive care unit. Medical complications included 3 episodes of acute respiratory distress syndrome and septic shock, acute renal failure requiring 150 days of continuous renal replacement therapy, and 51 ventilator days. Due to post-operative restrictions and/or medical complications, lower-extremity ROM was restricted for 63 days and supine position was restricted for 49 days. Rehabilitation interventions included PROM, AROM and continuous passive motion. Weight-bearing activities included a tilt table, Moveo™, standing frame, transfer and gait training with a rolling walker (RW). Positional interventions were sitting in a Total Lift Chair, serial casting, and custom AFO fabrication. Results On hospital day 215 the patient ambulated 15 feet using a platform walker and required assistance of 4 staff to support the ankle and foot. On hospital day 229, static custom AFOs were implemented and the patient ambulated 325 feet with contact guard assist (CGA). The static AFOs required frequent re-fabrication due to daily ROM progress. Adjustable dynamic AFOs were fabricated to decrease resource burden. With the dynamic AFOs, the patient progressed to 745 feet CGA on hospital day 258. The patient discharged to an acute rehabilitation center on hospital day 260. Conclusions Extensive medical, surgical and positional restrictions required innovative interventions by a multidisciplinary team. This resulted in the fabrication of dynamic custom AFOs for gait training. Utilization of these AFOs significantly increased activity tolerance and ambulation distance, and enabled eventual discharge to a rehabilitation center.

Design and Preliminary Evaluation of a New Ankle Foot Orthosis on Kinetics and Kinematics parameters for Multiple Sclerosis Patients.

Background: The damage of the central nervous system due to Multiple Sclerosis (MS) leads to many walking disorders in this population. However, current ankle-foot orthoses prescribed for improving walking disorders for these patients are not clinically cost-efficient.Objective: This study aimed to design and fabricate a dynamic ankle foot orthosis and a new spring-damper joint mechanism that could adapt the walking problems of MS patients and evaluate the immediate effect of the new orthosis on the speed, range of motion, moment, total work and ground reaction force during walking.Material and Methods: In this case-series study, after the design and fabrication of a new orthosis, the kinetics and kinematics of walking of four patients with MS were assessed in a case series study.Results: Walking speed improved with the new orthosis in two participants. The sagittal range of motion (ROM) increased for most of the participants. The sagittal moments increased for hip, knee and ankle joints in most of the measurements. The total joint work showed noticeable difference in the ankle joint. The increased values of vertical component of the ground reaction force (VGRF) were negligible and the increase in the impulse of VGRF was noticeable for only one participant. Conclusion: The new orthosis had positive effects kinetic and kinematic parameters of walking such as the increased velocity by two subjects and also a more normal sagittal ROM, moment and work, suggesting the potential usefulness of the new orthotic device for MS population.

Novel design for a dynamic ankle foot orthosis with motion feedback used for training in patients with hemiplegic gait: a pilot study

BackgroundWe designed a novel ankle foot orthosis (AFO), namely, ideal training AFO (IT-AFO), with motion feedback on the hemiparetic lower limb to improve ambulation in individuals with stroke-related hemiplegia. We, therefore sought to compare the kinematic parameters of gait between IT-AFO with and without dynamic control and conventional anterior-type AFO or no AFO.MethodsGait parameters were measured using the RehaWatch® system in seven individuals with hemiplegia (mean 51.14 years). The parameters were compared across four conditions: no AFO, conventional anterior AFO, IT-AFO without dynamic control, and IT-AFO with dynamic control, with three trials of a 10-m walk test for each.ResultsThe dorsiflexion angle increased during the swing phase when the IT-AFO was worn, and it was larger with dynamic control. These data can confirm drop foot improvement; however, the difference between the parameters with- and without-AFO control conditions was not significant in the swing phase. The IT-AFO with or without dynamic control enhanced the loading response to a greater extent between the hemiparetic and unaffected lower limbs than conventional AFO or no AFO. The duration of the stance phase on the hemiparetic lower limb was also longer when using IT-AFO with and without dynamic control than that when using conventional AFO, which improved asymmetry. User comfort and satisfaction was greater with IT-AFO than with the other conditions.ConclusionsThe IT-AFO with dynamic control improved gait pattern and weight shifting to the hemiparetic lower limb, reducing gait asymmetry. The difference with and without dynamic control of IT-AFO is not statistically significant, and it is limited by sample size. However, this study shows the potential of IT-AFO in applying positive motion feedback with gait training.Trial registrationTaipei Medical University-Joint Institutional Review Board. N201510010. Registered 12 February 2015. http://ohr.tmu.edu.tw/main.php.

Journal Vol – 15 No -7, July 2020 Journal &gt; Journal &gt; Journal Vol – 15 No -7, July 2020 &gt; Page 6 PERFORMANCE AND EMISSION CHARACTERISTICS OF GASOLINE-ETHANOL BLENDS ON PFI-SI ENGINE Authors: D.Vinay Kumar ,G.Samhita Priyadarsini,V.Jagadeesh Babu,Y.Sai Varun Teja, DOI NO: https://doi.org/10.26782/jmcms.2020.07.00051 admin July 26, 2020 Abstract: Alcohol based fuels can be produced from renewable energy sources and

Journal Vol – 15 No -7, July 2020 Journal &gt; Journal &gt; Journal Vol – 15 No -7, July 2020 &gt; Page 6 PERFORMANCE AND EMISSION CHARACTERISTICS OF GASOLINE-ETHANOL BLENDS ON PFI-SI ENGINE Authors: D.Vinay Kumar ,G.Samhita Priyadarsini,V.Jagadeesh Babu,Y.Sai Varun Teja, DOI NO: https://doi.org/10.26782/jmcms.2020.07.00051 admin July 26, 2020 Abstract: Alcohol based fuels can be produced from renewable energy sources and

Pengaruh Penggunaan Ankle Foot Orthosis Dinamis Terhadap Kecepatan Jalan Pada Anak Penderita Cerebral Palsy

Background: cerebral palsy is a non-progressive motor disorder that causes limited activity, paralysis, inability to control motion and is often accompanied by cognitive impairment or visual deficits.Children who experience cerebral palsy will definitely have limitations in the process of mobility. To help limitation of activity that occurs in children with cerebral palsy, ankle foot orthosis is used. Ankle foot orthosis is expected to help the patient in performing his activities at all times to give effect on the walking speed. In this research, actions performed by taking data before and after using dynamic ankle foot orthosis. Purpose of this research to determine the effect of the use of dynamic ankle foot orthosis on walking speed ​​in children with cerebral palsy ". Methods: This type of research is quasi experimental pre and post test design. The subjects used were spastic cerebral palsy spherical patients in the Pediatric &amp; Neurodevelopmental Therapy Center (PNTC) who had determined the inclusion and exclusion criteria. Number of subjects 15 people. Result: This research is based on data analysis result that wilcoxon test value got p = 0,001 (p &lt;0,05). Conclusion: This result indicates that there is an effect of the use of ankle foot orthosis dynamic on road speed in children with cerebral palsy.

Impact of a passive dynamic ankle foot orthosis on gait: Patients with dorsiflexion deficit.

Gait is the main mean of movement for Man, therefore an abnormality or deficiency related to it can be disabling. This deficiency is generally caused by a muscular dysfunction or some neurological ...

Immediate Effect of Vertibrace Dynamic Orthosis on Gross Motor Function in a Child with Spastic Cerebral Palsy: A Case Study

Children with spastic cerebral palsy usually display a decline in their gross motor functional abilities as compared to their peers of the same chronological age. Orthosis has been used widely to manage spasticity, prevent contractures, maintain the range of motion and improve motor function. The purpose of the study was to see the immediate effect of Vertibrace Dynamic Ankle Foot Orthosis on gross motor function abilities of a child with spastic cerebral palsy. A child with spastic cerebral palsy level I on gross motor function classification system was selected to wear the Vertibrace Dynamic Ankle Foot Orthosis. Gross motor abilities were assessed before and afterwearing the orthosis using the gross motor function measure. Vertibrace Dynamic Ankle Foot Orthosis showed an immediate improvement in the gross motor abilities by 3% in the child with spastic cerebral palsy with regard to kneeling, walking, running and jumping. Hence, Vertibrace Dynamic Orthosis can be prescribed for enhancement of gross motor abilities in children with spastic cerebral palsy. Further randomized control research about the effects of Vertibrace Dynamic Ankle Foot Orthosis is recommended by assessing a larger number of subjects and evaluating different variables.

The added value of orthotic management in the context of multi-level surgery in children with cerebral palsy

BackgroundTreatment of cerebral palsy includes an interdisciplinary concept and in more severe cases the well-established multi-level surgery (MLS). Different kinds of orthoses are typically part of postoperative treatment but there is a lack of knowledge about their additional benefit. Research questionDo ankle foot orthoses lead to an additional, measurable improvement of gait after MLS? Methods20 children with bilateral spastic cerebral palsy (9 retrospective, 11 in a postoperative clinical routine) were included. All had a preoperative gait analysis before MLS. Postoperatively, they were fitted with different ankle foot orthoses (AFO), depending on their individual needs. Dynamic ankle foot orthoses (DAFO), combined DAFO with additional dynamic, elastic shank adaptation (DESA) and ground reaction force AFOs (GRAFO) were used. Patients underwent a second gait analysis 1.5 (± 0.6) years postoperatively barefoot and with orthoses. Data analysis included testing for normal distribution (Shapiro-Wilk-Test) and further nonparametric statistical testing on basis of a Wilcoxon Single-Rank Test. ResultsThe operation produced changes in the hip, knee and ankle joint, and the pelvis. Spatiotemporal parameters showed significant changes due to additional use of the orthoses. Further, additional kinematic changes occurred at the hip, knee and ankle joint as well as the foot. The Gillette Gait Index (GGI) improved significantly by supplementary orthoses, but not by surgery alone. The Gait Profile Score (GPS) and Gait Deviation Index (GDI) rather showed changes due to the surgery. SignificanceMLS significantly improves GPS and GDI more than a year after surgery, which can be interpreted as an improvement in gait pattern. In contrast, the GGI is improved by additional postoperative orthotic treatment, which implies that walking ability itself has improved, rather than the gait pattern. Orthoses show a positive additional effect on surgical results at different anatomical levels. Spatiotemporal parameters are positively influenced solely by additional orthotic support.

State of the Prescription Process for Dynamic Ankle-Foot Orthoses

Purpose of Review Dynamic ankle-foot orthoses (AFOs) are assistive devices that can be prescribed to individuals with mobility limitations to support and align joints. Dynamic AFOs are a category of passive AFOs that can control ankle motion to address both ankle joint range of motion limitations and ankle muscle weakness. This control of motion is achieved through the dynamic AFO’s functional characteristics, namely bending stiffness, which need to be customized to each individual’s needs. However, current conventions for customizing dynamic AFOs for each individual are variable and often not clearly documented. The purpose of this review was to synthesize the current state of customizing functional characteristics of dynamic AFOs to provide a foundation for ultimately optimizing the prescription of AFOs.

Long-term effects of a dynamic ankle foot orthosis on a patient with cerebral palsy following ischemic perinatal stroke – A case study

Long-term effects of a dynamic ankle foot orthosis on a patient with cerebral palsy following ischemic perinatal stroke – A case study

Integrated effect of treadmill training combined with dynamic ankle foot orthosis on balance in children with hemiplegic cerebral palsy

Background and purposeMaintaining balance is a necessary requirement for most human actions. Most cerebral palsy children, who constitute a large portion in our country, continue to evidence deficits in balance, co-ordination, and gait throughout childhood. So, the purpose of this study was to determine the combined effects of treadmill and dynamic ankle foot orthosis on balance in spastic hemiplegic children. Subjects and methodsThirty spastic hemiplegic children from both sexes ranging in age from 7 to 11years represented the sample of the study. The degree of spasticity ranged from 1 to 1+ according to the Modified Ashworth Scale. They were assigned randomly into two groups of equal number (A and B). Each child in the two groups was evaluated before and after 3months of treatment for detecting the level of lower limb performance using the Peabody Developmental Test of Motor Proficiency and Stability indices using Biodex instrument system.Both groups received a designed physical therapy program for treatment of hemiplegic cerebral palsy children for 60min, in addition group B received treadmill training with dynamic ankle foot orthoses for 30min. ResultsSignificant improvements were observed in all measuring variables when comparing the pre and post-in the same group. Comparing the post-treatment variables, significant difference is revealed in favor of the group (B). ConclusionThe obtained results strongly support the combined effect of dynamic AFO with treadmill training as an additional procedure to the treatment program of hemiplegic cerebral palsy children.

Long-Term Outcomes of a Dynamic Ankle-Foot Orthosis on Gait Characteristics of a Service Member With Incomplete Nerve Injury to the Lower Extremity: A Case Report

This case study reports a 5-year follow-up of a 32-year-old male service member who suffered polytrauma in 2007 following a Humvee rollover in Afghanistan. The service member's injured left lower extremity was salvaged, but severe damage to the lumbosacral plexus and significant injuries to the pelvis, hip, and femur resulted in near total paralysis and foot drop of the left lower limb. Two years of multiple substandard ankle-foot orthotic devices pushed him to investigate a dynamic ankle-foot orthotic (DAFO) with energy storing capability, which allowed him to remain on active duty and deploy for a second tour while wearing the device. The anecdotal improvements described by this service member prompted a biomechanical analysis of walking and running gait, comparing a shoes only condition to the DAFO. Results of gait analysis demonstrated an improvement in spatial-temporal parameters in both walking and running, improved sagittal angles and moments at the ankle, knee, and hip, greater ankle stability through decreased dorsiflexion excursion, and a marked increase in ankle power while running. Most notably, the service member credits this device for substantial improvement in quality of life including total cessation of pain medication and return to regular vigorous activity.

Is there any relationship between orthotic usage and functional activities in children with neuromuscular disorders?

Contractures of Achilles tendons and gastrocnemius muscle deteriorate the performance in daily living activities of patients with neuromuscular diseases. Ankle-foot orthoses help to prevent the progression of deformities and to obtain optimal position of the joints to support standing and walking. To investigate the relationship between orthotic usage and functional activities in pediatric patients with different neuromuscular diseases. Retrospective study. A total of 127 subjects' physical assessment forms were analyzed. Functional level, type of orthoses, falling frequencies, ankle joint range of motion, and timed performance tests were examined in two consecutive dates with an interval of 3 months. A total of 91 patients were using orthoses while 36 patients were not within assessment dates. A total of 64 of 91 (70.3%) patients were diagnosed with Duchenne muscular dystrophy. A total of 81 (89.0%) subjects were using plastic ankle-foot orthoses for positioning at nights and 10 (11%) were using different types of the orthoses (knee-ankle-foot orthoses, dynamic ankle-foot orthoses, and so on) for gait in the study group. Night ankle-foot orthoses were not found to be effective directly on functional performance in children with neuromuscular diseases, although they protect ankle from contractures and may help to correct gait and balance. This retrospective study shows that the positive effects of using an ankle-foot orthosis at night are not reflected in the functional performance of children with neuromuscular diseases. This may be due to the progressive deteriorating nature of the disease.

Development of Dynamic Ankle Foot Orthosis for Therapeutic Application

In a population of aging with low birth rate, many elderly become bedridden because of their suffering from injuries or diseases that require a long period to heal and rehab. We developed the lowest cost of production while provides the highest performance and reliable prototype. The selective 27 parts were identified and used in this project including the cabling assembly for wiring. The other selective 14 parts are using other polymer materials such Acrylontrile Butadine Styrene (ABS) and Polypropylene. The alpha prototype was produced using FDM (Fuse Deposition Modeling). The model is fabricated by using real scale of (1:1) for the chosen conceptual design. Engineering drawing is the last process in design stage, where the final prototype must be verified as according to requirement and the related problem rise have been solved. The effective cost reduction newly designed DAFO is presented in this study. The functional test was conducted in the laboratory and based on human testify. The performance was good even though the prototype using rapid prototype materials. The controller board also functions as it programmed. The DC motor was performed a job based on signal provide by two (2) limit switch at the bottom part of lower foot. As a conclusion, The development of cost-effective new mechanism of dynamic ankle-foot orthosis was successfully fabricated in this current study. Further evaluation need to be tested accordingly prior to use as important device in rehabilitation therapy.

The Relationships Between Static Ankle Dorsiflexion Range of Motion and Dynamic Ankle Dorsiflexion, Inversion, and Foot Progression Angles During Sidestep Cutting Maneuver

The Relationships Between Static Ankle Dorsiflexion Range of Motion and Dynamic Ankle Dorsiflexion, Inversion, and Foot Progression Angles During Sidestep Cutting Maneuver

Ambulatory Function and Perception of Confidence in Persons with Stroke with a Custom-Made Hinged versus a Standard Ankle Foot Orthosis

Objective. The aim was to compare walking with an individually designed dynamic hinged ankle foot orthosis (DAFO) and a standard carbon composite ankle foot orthosis (C-AFO). Methods. Twelve participants, mean age 56 years (range 26–72), with hemiparesis due to stroke were included in the study. During the six-minute walk test (6MW), walking velocity, the Physiological Cost Index (PCI), and the degree of experienced exertion were measured with a DAFO and C-AFO, respectively, followed by a Stairs Test velocity and perceived confidence was rated. Results. The mean differences in favor for the DAFO were in 6MW 24.3 m (95% confidence interval [CI] 4.90, 43.76), PCI −0.09 beats/m (95% CI −0.27, 0.95), velocity 0.04 m/s (95% CI −0.01, 0.097), and in the Stairs Test −11.8 s (95% CI −19.05, −4.48). All participants except one perceived the degree of experienced exertion lower and felt more confident when walking with the DAFO. Conclusions. Wearing a DAFO resulted in longer walking distance and faster stair climbing compared to walking with a C-AFO. Eleven of twelve participants felt more confident with the DAFO, which may be more important than speed and distance and the most important reason for prescribing an AFO.