An AFO’s fundamental function is to manipulate the orientation and progression of force about the body to improve alignment and gait. Biomechanics is the core treatment target of orthotic care. In the realm of rehabilitation medicine, there have been calls to define the “active ingredients” that cause meaningful change in the treatment targets.¹,² It is important to define these active ingredients to enhance targeted outcomes.
In his work, Dijkers implores the field of rehabilitation medicine to disaggregate treatments—to describe the subcharacteristics of interventions—in order to more completely identify the treatment, specify reasonable goals, and explain how the treatment affects the outcome.¹ It would not be incorrect to say, for example, that taking medicine reduces pain. In the same way, it is not necessarily incorrect to say that utilizing an AFO improves gait. While not particularly incorrect, these statements are incomplete. A more useful statement would be that taking 200mg of ibuprofen per day reduces inflammation or that a custom composite AFO of 7 Nm/degree bending stiffness worn while walking improves gait efficiency. The revised statements are valuable because they identify essential subcomponents of the intervention and their anticipated effect on an outcome of interest. There is a clear cause-and-effect relationship drawn in this framework, which then allows the identified components to be manipulated to achieve a desired effect on the outcome.
Support authors and subscribe to content
This is premium stuff. Subscribe to read the entire article.
