From Opinion to Evidence: Multi-site Evaluation of Custom Dynamic Orthosis Best Practices

Inclusion Criteria:

• Between the ages of 18 and 65

• 2 or more years from a traumatic injury below the knee

• Ability to be fit with an orthosis

• Any of the following:

• Weakness of ankle plantarflexors (<4/5 on manual muscle test)

• Limited pain-free ankle motion (dorsiflexion (DF) <10° or plantarflexion (PF) <20°)

• Mechanical pain with loading to hindfoot/midfoot (>=4/10 Numerical pain ratingscale)

• Fusion or candidate for fusion of the ankle or hindfoot

• Candidate for amputation secondary to ankle/foot injury and impairment

Exclusion Criteria:

• Pain greater than 8/10 at rest

• Ankle weakness or spasticity as a result of spinal cord injury or central nervoussystem pathology

• Use of an orthosis including the knee

• Non-ambulatory

• Surgery on study limb anticipated in next 4 months

• Medical or psychological conditions that would influence functional testing (e.g.,severe traumatic brain injury, stroke, heart disease, vestibular disorder)

• Neurologic, musculoskeletal, or other conditions limiting function of thecontralateral extremity

• Uncorrected visual or hearing impairments

• Pregnancy

• Non-English speaking

• BMI > 40