Ankle foot orthosis-footwear combination tuning: an investigation into common clinical practice in the United Kingdom

Prosthet Orthot Int. 2015 Apr;39(2):126-33. doi: 10.1177/0309364613516486. Epub 2014 Feb 24.


Background: Ankle foot orthoses are used to treat a wide variety of gait pathologies. Ankle foot orthosis-footwear combination tuning should be routine clinical practice when prescribing an ankle foot orthosis. Current research suggests that failure to tune ankle foot orthosis-footwear combinations can lead to immediate detrimental effect on function, and in the longer term, it may actually contribute to deterioration.

Objectives: The purpose of this preliminary study was to identify the current level of knowledge clinicians have in the United Kingdom regarding ankle foot orthosis-footwear combination tuning and to investigate common clinical practice regarding ankle foot orthosis-footwear combination tuning among UK orthotists.

Study design: Cross-sectional survey.

Methods: A prospective study employing a multi-item questionnaire was sent out to registered orthotists and uploaded on to the official website of British Association of Prosthetists and Orthotists to be accessed by their members.

Results: A total of 41 completed questionnaires were received. The results demonstrate that only 50% of participants use ankle foot orthosis-footwear combination tuning as standard clinical practice. The most prevalent factors preventing participants from carrying out ankle foot orthosis-footwear combination tuning are a lack of access to three-dimensional gait analysis equipment (37%) and a lack of time available in their clinics (27%).

Clinical relevance: Although, ankle foot orthosis-footwear combination tuning has been identified as an essential aspect of the prescription of ankle foot orthoses, the results of this study show a lack of understanding of the key principles behind ankle foot orthosis-footwear combination tuning.

Keywords: Ankle foot orthosis–footwear combination tuning; ankle foot orthosis; gait analysis.

MeSH terms

  • Ankle*
  • Biomechanical Phenomena
  • Cross-Sectional Studies
  • Equipment Design / standards*
  • Equipment Design / trends
  • Foot Orthoses / standards*
  • Foot*
  • Gait / physiology
  • Health Personnel / education
  • Humans
  • Mobility Limitation*
  • Practice Patterns, Physicians' / standards*
  • Practice Patterns, Physicians' / trends
  • Prospective Studies
  • Shoes*
  • Surveys and Questionnaires
  • United Kingdom