Exploring physical sensor integration in the design of cost-effective and wearable instrumented ankle foot orthosis: A systematic review

DOI: https://doi.org/10.33024/minh.v8i6.1288

Authors

  • Fika Trifani Poltekkes Kemenkes Jakarta I
  • Abdul Halim Jurusan Ortotik Prostetik, Poltekkes Kemenkes Jakarta I

Ankle Foot Orthosis Gait Analysis Mechanical Properties Physical Sensors

Abstract

Background: The mechanical properties of Ankle-Foot Orthoses (AFOs) play a vital role in enhancing mobility and improving the quality of life in individuals recovering from stroke. Parameters such as stiffness, alignment, and kinetic-kinematic characteristics are critical aspects that require optimization in AFO design and evaluation.

Purpose: To investigate the advancement of physical sensor technologies applied in AFO systems. It focuses on enabling practitioners and researchers to obtain objective, real-time data on fitting outcomes, while addressing the limitations associated with traditional, bulky, or high-cost instrumentation.

Method:  A literature-based review was conducted to analyze the implementation of various physical sensors integrated into AFOs. Sensor selection was examined in relation to targeted biomechanical outcomes, with attention given to each sensor's operational strengths and constraints to inform optimal usage.

Results: Findings indicate that physical sensors significantly enhance data acquisition related to AFO fitting and performance by offering accurate, efficient, and user-friendly measurement capabilities. The diversity of available sensors allows for customization based on specific research or clinical objectives, although careful consideration must be given to each sensor's limitations.

Conclusion: The integration of physical sensors into AFO systems represents a promising direction in orthotic development, facilitating evidence-based assessments through wearable and cost-effective technologies. Strategic sensor selection is essential to maximizing the accuracy and utility of AFO outcome measurements in both clinical and research settings.

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References

Adiputra, D., Nazmi, N., Bahiuddin, I., Ubaidillah, U., Imaduddin, F., Abdul Rahman, M. A., & Zamzuri, H. (2019, January). A review on the control of the mechanical properties of ankle foot orthosis for gait assistance. In Actuators (Vol. 8, No. 1, p. 10). MDPI.

Arch, E. S., Stanhope, S. J., & Higginson, J. S. (2016). Passive-dynamic ankle–foot orthosis replicates soleus but not gastrocnemius muscle function during stance in gait: insights for orthosis prescription. Prosthetics and orthotics international, 40(5), 606-616.

Bath, P. M., & Lees, K. R. (2000). Acute stroke. BMJ, 320(7239), 920-923.

Bleyenheuft, C., Bleyenheuft, Y., Hanson, P., & Deltombe, T. (2010). Treatment of genu recurvatum in hemiparetic adult patients: a systematic literature review. Annals of physical and rehabilitation medicine, 53(3), 189-199.

Bregman, D. J. J., Rozumalski, A., Koops, D., De Groot, V., Schwartz, M., & Harlaar, J. (2009). A new method for evaluating ankle foot orthosis characteristics: BRUCE. Gait & posture, 30(2), 144-149.

Buurke, J. H. (2005). Walking after stroke co-ordination patterns & functional recovery.

Cappa, P., Patane, F., & Pierro, M. M. (2003). A novel device to evaluate the stiffness of ankle-foot orthosis devices. J. Biomech. Eng., 125(6), 913-917.

Daryabor, A., Kobayashi, T., Yamamoto, S., Lyons, S. M., Orendurff, M., & Akbarzadeh Baghban, A. (2022). Effect of ankle-foot orthoses on functional outcome measurements in individuals with stroke: a systematic review and meta-analysis. Disability and rehabilitation, 44(22), 6566-6581.

Gupta, S., Loh, K. J., & Pedtke, A. (2020). Sensing and actuation technologies for smart socket prostheses. Biomedical engineering letters, 10(1), 103-118.

Harlaar, J., Brehm, M., Becher, J. G., Bregman, D. J., Buurke, J., Holtkamp, F., & Nollet, F. (2010). Studies examining the efficacy of ankle foot orthoses should report activity level and mechanical evidence. Prosthetics and orthotics international, 34(3), 327-335.

Kobayashi, T., Orendurff, M. S., Singer, M. L., Gao, F., Daly, W. K., & Foreman, K. B. (2016). Reduction of genu recurvatum through adjustment of plantarflexion resistance of an articulated ankle-foot orthosis in individuals post-stroke. Clinical Biomechanics, 35, 81-85.

Kim, B. H., Hong, S. H., Oh, I. W., Lee, Y. W., Kee, I. H., & Lee, S. Y. (2021). Measurement of ankle joint movements using IMUs during running. Sensors, 21(12), 4240.

Kobayashi, T., Orendurff, M. S., Singer, M. L., Gao, F., & Foreman, K. B. (2017). Contribution of ankle-foot orthosis moment in regulating ankle and knee motions during gait in individuals post-stroke. Clinical Biomechanics, 45, 9-13.

Kobayashi, T., Leung, A. K., & Hutchins, S. W. (2011). Techniques to measure rigidity of ankle-foot orthosis: a review. Journal of rehabilitation research and development, 48(5), 565-576.

Kobayashi, T., Orendurff, M. S., Hunt, G., Gao, F., LeCursi, N., Lincoln, L. S., & Foreman, K. B. (2019). The effects of alignment of an articulated ankle-foot orthosis on lower limb joint kinematics and kinetics during gait in individuals post-stroke. Journal of biomechanics, 83, 57-64.

Lakany, H. (2008). Extracting a diagnostic gait signature. Pattern recognition, 41(5), 1627-1637.

Lamkin-Kennard, K. A., & Popovic, M. B. (2019). Sensors: natural and synthetic sensors. Biomechatronics; Academic Press: Cambridge, MA, USA, 81-107.

Ielapi, A., Vasiliauskaite, E., Hendrickx, M., Forward, M., Lammens, N., Van Paepegem, W., & De Beule, M. (2018). A novel experimental setup for evaluating the stiffness of ankle foot orthoses. BMC Research Notes, 11(1), 649.

Li, Y. D., & Hsiao-Wecksler, E. T. (2013, June). Gait mode recognition and control for a portable-powered ankle-foot orthosis. In 2013 IEEE 13th International Conference on Rehabilitation Robotics (ICORR) (pp. 1-8). IEEE.

Lunsford, T. R., Ramm, T., & Miller, J. A. (1994). Viscoelastic properties of plastic pediatric AFOs. JPO: Journal of Prosthetics and Orthotics, 6(1), 3-9.

Miyake, T., Kobayashi, Y., Fujie, M. G., & Sugano, S. (2020). Gait event detection based on inter-joint coordination using only angular information. Advanced Robotics, 34(18), 1190-1200.

Miyazaki, S., Yamamoto, S., & Kubota, T. (1997). Effect of ankle-foot orthosis on active ankle moment in patients with hemiparesis. Medical and Biological Engineering and Computing, 35(4), 381-385.

Nouri, A., Wang, L., Li, Y., & Wen, C. (2023). Materials and manufacturing for ankle–foot orthoses: a review. Advanced Engineering Materials, 25(20), 2300238.

Owen, E. (2010). The importance of being earnest about shank and thigh kinematics especially when using ankle-foot orthoses. Prosthetics and orthotics international, 34(3), 254-269.

Papi, E., Maclean, J., Bowers, R. J., & Solomonidis, S. E. (2015). Determination of loads carried by polypropylene ankle–foot orthoses: A preliminary study. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, 229(1), 40-51.

Ploeger, H. E., Waterval, N. F., Nollet, F., Bus, S. A., & Brehm, M. A. (2019). Stiffness modification of two ankle‐foot orthosis types to optimize gait in individuals with non‐spastic calf muscle weakness–a proof‐of‐concept study. Journal of foot and ankle research, 12(1), 41.

Ringleb, S. I., Armstrong, T., Berglund, L. J., Kitaoka, H. B., & Kaufman, K. R. (2009). Stiffness of the Arizona ankle-foot orthosis before and after modification for gait analysis. JPO: Journal of Prosthetics and Orthotics, 21(4), 204-207.

Santini, S., Marinozzi, A., Herrera-Pérez, M., Tejero, S., Wiewiorski, M., de Cesar Netto, C., & Valderrabano, V. (2023). The classic three-month post-operative adaptation phase in foot and ankle surgery—an expert perspective. Journal of Clinical Medicine, 12(19), 6217.

Santos, V. M., Gomes, B. B., Neto, M. A., & Amaro, A. M. (2024). A systematic review of insole sensor technology: recent studies and future directions. Applied Sciences, 14(14), 6085.

Sutdet, P., Polhan, N., Prakotmongkol, V., Poomulna, J., Trifani, F., Iswana, T., & Tharin, S. (2019). The effect of tibia inclination on gait pattern of stroke patients with genu recurvatum who wear an Ankle Foot Orthosis: A pilot study. Technology and Disability, 31(3), 77-82.

Suwanwela, N. C. (2014). Stroke epidemiology in Thailand. Journal of stroke, 16(1), 1.

Waterval, N. F., Nollet, F., Harlaar, J., & Brehm, M. A. (2019). Modifying ankle foot orthosis stiffness in patients with calf muscle weakness: gait responses on group and individual level. Journal of NeuroEngineering and Rehabilitation, 16(1), 120.

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Published

2025-09-02

How to Cite

Exploring physical sensor integration in the design of cost-effective and wearable instrumented ankle foot orthosis: A systematic review. (2025). MIN, 8(6), 815-825. https://doi.org/10.33024/minh.v8i6.1288