Ground reaction forces, center of pressure, and duration of stance with and without an ankle-foot orthosis

We analyzed the effects of an ankle-foot orthosis (AFO) on the ground reaction forces, the position of the center of pressure, and the timing of stance phase events during walking in 18 healthy volunteers between the ages of 19 and 38 years. The magnitude and direction of the ground reaction forces and the locus of the center of pressure were recorded every one-sixtieth of a second during free-speed ambulation. The horizontal force components of the ground reaction force were plotted vectorially, and the vertical force component was displayed by its magnitude expressed in percentage body weight. All this information was superimposed on the subject's footprint and statistically analyzed, comparing right to left, narrow to wide, and ipsilateral to contralateral use of an AFO. The results showed a significant reduction in the mean duration of the stance phase of 4.83% (p less than 0.05) with the AFO. This reduction was due primarily to the significant reduction during midstance of 7% (p less than 0.025), which was more pronounced with the use of the wide AFO. Using an AFO also resulted in a mean increase of 20% (p less than 0.05) in the vertical force magnitude at the end of push-off. With the use of an AFO, there was a shift of the point of impact at heel strike to a more posterior location and a shift of the trajectory of the center of pressure to a more lateral position throughout the stance phase. These changes should be kept in mind when prescribing an ankle-foot orthosis.