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Ankle foot orthosis–footwear combination tuning: An investigation into common clinical practice in the United Kingdom

Background: Ankle foot orthoses are used to treat a wide variety of gait pathologies. Ankle foot orthosis–footwear combination tuning should be routine clinical practice when prescribing an ankle foot orthosis. Current research suggests that failure to tune ankle foot orthosis–footwear combinations can lead to immediate detrimental effect on function, and in the longer term, it may actually contribute to deterioration. Objectives: The purpose of this preliminary study was to identify the current level of knowledge clinicians have in the United Kingdom regarding ankle foot orthosis–footwear combination tuning and to investigate common clinical practice regarding ankle foot orthosis–footwear combination tuning among UK orthotists. Study design: Cross-sectional survey. Methods: A prospective study employing a multi-item questionnaire was sent out to registered orthotists and uploaded on to the official website of British Association of Prosthetists and Orthotists to be accessed by their members. Results: A total of 41 completed questionnaires were received. The results demonstrate that only 50% of participants use ankle foot orthosis–footwear combination tuning as standard clinical practice. The most prevalent factors preventing participants from carrying out ankle foot orthosis–footwear combination tuning are a lack of access to three-dimensional gait analysis equipment (37%) and a lack of time available in their clinics (27%). Clinical relevance Although, ankle foot orthosis–footwear combination tuning has been identified as an essential aspect of the prescription of ankle foot orthoses, the results of this study show a lack of understanding of the key principles behind ankle foot orthosis–footwear combination tuning.