The effect of custom-made braces for the ankle and hindfoot on ankle and foot kinematics and ground reaction forces

Arch Phys Med Rehabil. 2006 Jan;87(1):130-5. doi: 10.1016/j.apmr.2005.08.120.


Objective: To assess the effects on gait of custom-made polypropylene orthoses: ankle-foot orthosis (AFO), rigid hindfoot orthosis (HFO-R), and articulated hindfoot orthosis (HFO-A).

Design: Experimental assessment.

Setting: Institutional practice, motion analysis laboratory.

Participants: Twenty asymptomatic normative subjects.

Interventions: Not applicable.

Main outcome measures: Three-dimensional kinematics, ground reaction force, and time-related factors in 4 conditions: shoe only, and shod with the AFO, HFO-R, and HFO-A.

Results: The AFO and HFO-R limited sagittal and coronal plane ankle-hindfoot motion. The HFO-A limited hindfoot coronal motion while allowing normal sagittal motion. At the midfoot, the AFO and HFO-A limited transverse motion, but the HFO-A also limited sagittal and coronal motion. Use of the HFO-R resulted in exaggerated midfoot sagittal and coronal motion. Braces that limited motion to a greater degree were associated with more atypical kinetic variables, indicative of less dynamic gait. The HFO-A resulted in ground reaction forces most similar to unbraced conditions.

Conclusions: Alteration in gait was affected by orthosis design. Orthoses with a rigid component crossing a joint restricted motion at that joint, but potentially compromised typical gait kinetic factors. For immobilizing the hindfoot, the HFO-A may be more comfortable and still provide more stability than the HFO-R or AFO.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Ankle Joint / physiology*
  • Biomechanical Phenomena*
  • Braces*
  • Cohort Studies
  • Equipment Design
  • Equipment Safety
  • Female
  • Foot / physiology*
  • Gait / physiology*
  • Humans
  • Male
  • Middle Aged
  • Probability
  • Range of Motion, Articular / physiology
  • Reference Values
  • Sensitivity and Specificity
  • Stress, Mechanical
  • Weight-Bearing