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Shank-to-Vertical Angle in Ankle-Foot Orthoses

A Comparison of Static and Dynamic Assessment in a Series of Cases

Eddison, Nicola MSc; Healy, Aoife PhD; Needham, Robert MSc; Chockalingam, Nachiappan PhD

JPO: Journal of Prosthetics and Orthotics: October 2017 - Volume 29 - Issue 4 - p 161–167
doi: 10.1097/JPO.0000000000000141
CME Article

Background Tuning of ankle-foot orthosis footwear combinations (AFO-FC) has been shown to be effective in aligning the ground reaction force (GRF) closer to the joint rotation center of the lower limbs. The notion of “tuning” the AFO-FC is largely dependent on the shank-to-vertical angle (SVA), which is measured while the subject is static but is meant to represent the SVA in mid-stance.

Objectives The aim of this study was to compare the SVA measured in standing position with the SVA at temporal mid-stance (TMST) in a series of cases.

Study Design This study is a case series.

Methods Four participants had their AFO-FC tuned to optimum SVA using video-based gait analysis with GRF overlay. Initially, the SVA was measured with the subject standing in relaxed stance on the force plate with approximately equal weight on both feet. The SVA was then assessed at TMST.

Results The measurement of the SVA of the AFO-FC in relaxed stance seems to be the same as the measurement of the SVA in TMST.

Conclusions Measuring the SVA of the AFO-FC in relaxed stance is an accurate way of determining the SVA at TMST.

Clinical Relevance Ankle-foot orthosis footwear combination tuning is considered an essential aspect of AFO prescriptions. The SVA is a key principle of AFO-FC tuning. The method for determining the SVA has yet to be tested to ensure that the static measurement correlates to the dynamic measurement during gait.

NICOLA EDDISON, AOIFE HEALY, ROBERT NEEDHAM, and NACHIAPPAN CHOCKALINGAM are affiliated with the Faculty of Health Sciences, Staffordshire University, Stoke-on-Trent, United Kingdom.

Disclosure: The authors declare no conflict of interest.

Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Footwear were manufactured and supplied by Salts-Techstep, United Kingdom.

Correspondence to: Nicola Eddison, MSc, CSHER, Faculty of Health Sciences, Staffordshire University, Leek Road, Stoke-on-Trent ST4 2DF, United Kingdom; email:;

© 2017 by the American Academy of Orthotists and Prosthetists.