Investigation Of Kinetic And Kinematic Parameters Physical Education Essay

probe Of Kinetic And Kinematic Parameters Physical Education EssayThis cultivation reviewing the biomechanical force- come out of the closets of the orthosis on human yard manakin and a specific vitrine of ankle origination orthosis (AFO) with rocking chair bottom was employ for the pilot study. Walking gradation cycle background theory and related c tout ensembles definition is explained as the introduction. A drop review on AFO functionality and faculty on yard correction via laboratory examination is done. The review is main(prenominal)ly expressed from biomechanism undertake with the use of kinematics and energizing familiarity. From the reviewed process, it is no doubt to clarify that AFO enable to embarrass and correct pathological yard for transgress amendment. Motion digest technique apply photographic camera found system to conduct laboratory essay on human tread is studied too. A sequence of procedures is institution for further study, which co nsist of compositors case leadment, rocker AFO fabrication, customization, laboratory experiment testing apply Vicon re mess abbreviation system, data collection and analyse. every focus, pilot studys results ar included in result and discussion. A healthy woman was employ as the subject in the pilot study who undergo 2 types of paseoing, which ar moveed b ar pluck and with AFO form. As conclusion, the review go outs evidence that the assimilate for of AFO in altering human whirling stride is momentous and further study is prerequisite to be proceeded for break-dance describe AFO functionality.AcknowledgementThe first give thanks goes to Prof. Dr. Ir. Wan Abu Bakar Wan Abas, my supervisor for this graduation project. His resultingness and forbearing in breeding and guide me every to accomplish the tasks or when I facing problems during the clock, were hence appreciated. My grateful thank goes to Dr Noor Azuan Abu Osman with his en consequentlyiasm of sharin g valuable knowledge and tout ensemble in every last(predicate) mental of challenges gave by him, were definitely brought me chances to urinate as an professional biomedical engineer. I express much gratitude to young woman Arezoo Eshraghi too, for her guidance and assi perspective brought to the suavity of my thesis study.Nevertheless, I would like to thank for all the hard work done by my faculty, especially to the Coordinator for the Graduation Project, Dr.Belinda Murphy, assistant for the project Miss Khairunnisa Hasikin and all the stuff of Biomedical Engineering Department.Table of Contents numerate of shapesList of TablesList of Symbols and AbbreviationsAFO Ankle Foot OrthosisIC Initial meetingLR Loading ResponseMST Mid StanceTST Terminal StanceTO walking OffISW Initial devolveMSW Mid snubTSW Terminal shedDF Dorsi creasePF PlantarflexionKF Knee flexureKE Knee addendumHF Hip FlexionHE Hip ExtensionPTB Patellar Tendon BearingToA Types of AFOCGC understand Group ConditionIntroductionHuman motive power defined as social run from one place to a nonher and a numbers of ship canal could be done to achieve it, walking, use of a bicycle, wheelchair argon examples of loco operation (S middlet, 1990). In this study, walking step is the targeted locomotion. Walking is a cyclic battlefront interlaced betwixt left and right foot with at least(prenominal) one foot existence contact with the ground at all times in a certain periodic pattern (Ounpuu, 1995). A systemic analysis and parameter is required to evaluate walking tempo progenyively and biomechanics knowledge has been introduced to solve for this. It is a brand new term developed around the grade of 1970s which integrating technology mechanics knowledge into biological system.Biomechanics is actually applied in step analysis by the ancient scientists a few(prenominal) centuries ago (Martin, 1999). Biomechanics study on the step analysis has been started since the year of 1680 by Ar istotle on the pace of animals and in the year of 1890, Christian Wilhelm Braune an anatomist and Otto Fischer were started investigating human yard from biomechanics aspects (Martin, 1999). Scientists enthusiasm toward human rate analysis never shelved, it continue evolutes until today. At present, biomechanics investigation in gait analysis is able to provide profusion information for clinical practitioner to assess diligent locomotion effectively. For antecedents, a pathology gait pattern by patient can be visualized by measuring biomechanical parameters, standard length, length, joint angles, forces and etcetera. To evaluate how well the sermon im try outs patient ambulatory level, biomechanics knowledge applied too.Main interest of this study is not only taper on human walking gait, scarce to a fault to check up on the flair orthotics alters its users gait pattern from biomechanics aspect. Orthosis is a medical appliance major used in orthopedics field for the purpo se to die hard, alter, and align injured psycheate segments involve in frame movement (Edelstein Bruckner, 2001). In this study, the ankle foot orthosis (AFO) with additional rocker sole is chose as the orthosis in this study. anatomy 1.1(a) shown a solid AFO and (b) rocker bottom. symbol 1. Solid AFORocker AFO is a kind of treatment apply to diabetic patient who has plantar foot ulcer risk and with ankle joint mobility difficulty. From statistical analysis from University Malaya Medical focus on Diabetic Foot Clinics, plantar foot wound treatments on diabetic patient possess the high upest number of among other kind of treatment and also footwear is the highest treatment modality among others in 2008 and 2009. This statement has support and encourages the need to carry out this study as number of diabetic patient is join on gradually every year.AFO is worn on low- cut backer purpose and around foot to support and correct ankle side of meat. Patient having diabetes, ex perient bones segment fracture, cerebral palsy, spinal cord injury, tendon disfunction and limb disorder patient who ankle failed to support their body free weightiness while walking atomic number 18 greenly suggested by orthotist to use an AFO to improve gait routine and to minimise further injury risk (Edelstein Bruckner, 2001). Besides that, rocker sole is a creature use to reduce thrust on the forefoot and use to transmit squeeze from high pressure to low pressure theater meanwhile by loading the pressure exerted to savage area (Albright Woodhull-Smith, 2009). To be telling to orthosis definition, an AFO with rocker sole should not add up more than burdens to patient in increase energy demand or cause any long term side effects. Consequently, investigating AFO biomechanical implementation in aiding and influencing wearer locomotion matchly becomes an important study.Three dimensional (3D) gait analysis systems are laboratory equipment involve the use of reflecti ve brands that fit(p) on subjects interest body segments as the landmarks (Davis, Deluca, Ounpuu, 2000). It has been use widely in clinical gait analysis services and research. The video camera based system employ 2 to 7 infrared cameras allocated on the measurement volume to record subject motion or markers trajectories in meticulous as shown in Figure 1.2 (a) (b). The entire system applies stereophotogrammetric techniques to produce apiece(prenominal) markers 3D coordinates from the both(prenominal) dimensional (2D) images capture by each of the camera (Davis, et al., 2000). This 3D system digitized subject movement in real time into frames depending on sampling rate set. The frame to frame analysis provides better motion visualization and subsequently from the 3D images generated it makes the chess opening to compute a more complete description towards the dynamic gait in scathe of biomechanical parameters. Kinematic, kinetic, and temporal parameters or some other d ynamic gait versatiles are able to be obtained from this system. During the entire study, Vicon Nexus 1.4 motion analysis system is employ to record and examine subjects walking gait pattern. Kinematic and kinetic parameters are extracting to further illustrate rocker AFO effects on its user gait pattern. Figure 1.2(c) presented a mon happen upon hooping frame image capture using 3D motion analysis systems.http//rehablab.creighton.edu/share/sharedfiles/UserFiles/image/Camera1.jpghttp//www.med.nyu.edu/rehab design/images/vicon8cameras.jpg(b) (c)Figure 1. (a) infrared Camera (b) Overview of Motion Analysis Laboratory (c) Frame Images Capture from unseeable Camera1.1 TheoryWalking gaitNormal one complete gait cycle consists of billet point and cut shape in a proportion of 60% and 40%, singly. A normal swelled will spent approximately 60% of total gait epoch for heel strike to toe out ( em lieu phase) and 40% for initial cast to terminal swing (swing phase). Stance phase is the event when foot striking on ground and body passes over the top of it whereas swing phase is when the same foot moves forwards in the air.Figure 1. Stance and Swing Phase Propotion.Stance phase is defined from initial contact, loading response, mid locating and terminal stance (toe off). Swing phase is defined from the congressman toe off, initial swing, mid swing and terminal swing (Ounpuu, 1995). Figure 1.4 illustrates the phases of the gait cycle shown with the corresponding position for sagittal plane motion.http//www.ncbi.nlm.nih.gov/ prevailshelf/picrender.fcgi?book=physmedrehabpart=A8414blobname=ch6f6-2.jpgFigure 1. Gait cycle phases (Carson, M.D. 1995)Stance phaseInitial contact(IC) (0% of the gait cycle), it occur when foot contact to ground.Loading response (LR) (0-10% of the gait cycle), during this stage, knock absorption occurred with stability remain and body more forwarded. This is the first iterate support happened.Mid stance (MST) (10%-30% of the gait cycle ), the first single offshoot support instance, purpose of this phase is to advance body over the stance phase limb while stability is substantiateed.Terminal stance (TST) (30%-50% of gait cycle), or sometimes called toe off(TF) single support ended when the thinking(a) limb contact with floor and in this phase, body still being advanced through the stance foot through the forward pop off of the trunk.Toe off (TO) (60% of the gait cycle), when foots toes are nearly to go forth floor.Swing PhaseInitial Swing (ISW) (60%-73% of the gait cycle), second single support phase and begins when the foot leaves the ground until it passes opposite the stance limb.Mid swing (MSW) (73%-87%), continue advance the swing limb while providing headroom of stance foot.Terminal swing (TSW) (87%-100%), swing subdivision already in cooking for the next stance phase.In order for a person to walk normally, the locomotor system must(prenominal) fulfill tetrad requirements. Firstly, stability of foo t is essential to ensure each foot capable to withstand body weight with no collapsing. Secondly, during single leg support in stance phase, balance shall sustain for that particular period. Thirdly, swinging leg must be able to move in a sequence reaching the position where it can take over the supporting leg. Lastly, locomotor system must provided substantial power to induce limb movements and to advance the body (Whittle, 1993). ghoulish gait produce deviant walking patterns when it fails to obey any of the four requirements stated above. It can be indentified obviously by visual or using appropriate clinical gait analysis method. This abnormal gait maybe performed unintended by the subject collectible to the weakness, spasticity or dishonor occurred onto them. Besides, sometimes the abnormal gait is also consequences of the compensatory motion by some other problem. each abnormal gait should be corrected using an orthotics or braces in order to minimize overload harms on mus cles, joints and bones.Kinematic and kinetics of human gaitThe terms kinematic and kinetics are branches of biomechanics, which are commonly employed in gait assessment. Kinematic describing a body movement without considering its causes for example forces and torque. Camera is a example of kinematic equipment which only used to ob arrange limbs movement without but without providing information of force involved (Whittle, 1993). Meanwhile, kinetic is more in explaining the body motion with it causes like mass and forces exert onto the system. Moment, force, mass, and speedup are the examples which usually utilize the kinetic of the systems. Example of kinematic equipment in gait analysis is force plate, which measure force exerted by foot but without the position and angle of the leg segment (Whittle, 1993).Kinematic of human gait careenPelvis, hip, knee and ankle angle are the common kinematic parameters used in gait analysis. Each anatomical angle can be discover from sagittal , coronal and transverse plane. During normal gait, most of the motion occurred in sagittal plane meanwhile coronal and transverse plane name great motion in pathological gait(Ounpuu, 1995). Table 1.1 is a summary on the each segment movement with admire to gait cycles phases.Table 1. abridgment of the Major components of gait with follow to the phase of the gait cycle.Phase crossroads MovementAnkleKneeICNeutral Positionfull KELRPFKFMSTDFKETSTDFKETFPFKFISWPeak PF then DF rapidlyKF rapidly to peakMSWPeak DF convey with peak KF and KE rapidlyTSWPFKEPlantarFlexion(PF), DorsiFlexion(DF), Knee Flexion(KF), Knee Extension(KE), Hip Flexion(HF) and Hip Extension (HE)Kinetics of human gait Ground reaction forcesWhen a person is walking, forces will apply toward ground on each step taken. consort to Newtons Third Law, a force will generate that is equal order of magnitude but in the opposite direction to the force applied by the foot, and it is called ground reaction forces.The vertical component of ground reaction forces is climbing from heel strike and shot 112% of body weight during 25% of gait. At the mean time, the opposite leg inspires the centre of gravity upward and thus vertical force descends to around 80% of body weight. At the instance of heel off, centre of gravity start to move downward therefore vertical forces raise again to around 115% of body weight at almost 80% of stance phase. Vertical forces descend greatly right after the peak vertical forces as the foot is propel to swing phase. Figure 1.5 shown the overview of vertical forces exert on the stance leg.Figure 1. Ground reaction forcesLiterature ReviewTypes of AFOAFO is categorized into many types depending on its functionality, jut out nest and usages. AFOs are generally classified into five main branches rigid AFOs, hinged AFOs, Patellar Tendon Bearing (PTB) AFOs, posterior leaf give AFOs and ground reaction AFOs. Each AFOs functionality will be discussed in breaker point later.Table 2 . Summary on Types of AFO and description (Edelstein Bruckner, 2001)Types of AFOFeaturesSolid AFOSolid ankle-foot orthosis (AFO), Plastazote-lined (Photo courtesy of Hersco Orthotic Labs.) gelded anterior to malleoli surrounds ankle.Restrict ankle motion without allows any plantarflexion.During loading response, maintain a rigid foot and ankle alignmentHinged AFOhttp//www.appliedbiomechanics.com/ stand/Home/Hinged_AFO.gifAdd mechanical joint around ankle to permit motion.Degrees of motion are determined by the joint design.Allow dorsiflexion and plantar flexion without subdueion.PTB AFOhttp//www.capstoneorthopedic.com/Orthoservicespages/afo/afo_clip_image018.pngCast until patella area as to transfer weight from plantar foot to patella tendonResponsible for off loading effect. screwing Leaf Spring AFOhttp//www.neuromuscular-orthotics.com.au/images/PLS%20AFO.jpgTrimmed posterior to malleoli, allow plastic to resileFunction as a spring during swing phase off loaded, allow plantar fl exion.Ankle motion is permitted by deformation and repercussion of the plastic strip.Gait analysis methodReliability of the result obtained from motion analysis is mainly relay on the markers placement (Ferrari, et al., 2008 A. Leardini Benedetti, 1999). Therefore, marker location is depending strongly to the objective of the research or study. The inconsistency of marker placement is generally a crucial factor contribute to the data fluctuation because each marker represent different body landmark respectively too. A full body marker set is lots applying to investigate whole body posture and gait. A total of 60 markers with 22 on each leg, 5 on pelvis and 11 on trunk are consider as a complete marker set. It has been applied to evaluate treatment gait pattern correction or diseases caused pathological gait for example cerebral palsy and diabetic patient (Radtka, Skinner, Elise Johanson, 2005 Sawacha, et al., 2009). Only trim down limb markers set were use more often in gait motion analysis (Abel Juhl, 1998 Fatone, Gard, Malas, 2009 Alberto Leardini, et al., 2007 Yokoyama Sashika, 2005). There also few study make their focus on gait assessment on AFO user which only applied reflective marker on start limb as anatomic landmarks for the whole experiment (Abel Juhl, 1998 Fatone, et al., 2009). When come crosswise with gait analysis, researchers putting more interest on the set about limbs kinetic and kinematic parameters rather than upper limb because the locomotion trajectories occurred mainly in leg segments.In analyzing treatment effect for a particular illness or disease, control group or control variable present to serve a better comparison to the tested result. While evaluating the relation of orthosis treatment and gait assessment caused by it, subject under unshod peg down sometimes appeared as the control variable (Abel Juhl, 1998 Lam, Leong, Li, Hu, Lu, 2005 Romkes Brunner, 2002). However, in some cases, barefoot control does not prov ide a comparable opportunity and it is not practical as in real life subjects usually walk with foot wear. Besides, as of experimental approach, it has shown that subjects walking with footwear is more relative to evaluate AFO efficacy with contrast to barefoot ((Radtka, et al., 2005)Churchill et al., 2003 Radtka et al., 2005). Two reviewed denominations obtained result with subject walking while wore footwear alone (Bleyenheuft Hanson, 2010 Fatone, et al., 2009). There is one of the article used able bodied subject with footwear alone to acquire control variables (Fatone et al., 2009). Either way of choosing control group is proportion to the research behavior and objectives. Therefore, appropriate consideration should be taken while calculative a research methodology.Gait analysis parametersIn general, AFO is use as hinderion of foot deformity, limit joint movement, position and provide stability. The effect of AFO in serving all these functionality is been studied via various method from honest to more sophisticated gait analysis technique. Majority of the reviewed papers adoptive video-camera based system to collect and record data. (Abel Juhl, 1998 Fatone, et al., 2009 Lam, et al., 2005 Radtka, et al., 2005 Romkes Brunner, 2002 Yokoyama Sashika, 2005). Kinematic and temperal parameters are the two common results obtained from ambulation analysis.Temperal parameterCadanceCadence, defined as number of steps taken in a given period and its unit is steps over minute. In gait analysis, cadence becomes a popular parameter to evaluate AFO efficacy. Researches which lose examined subjects gait with dynamic AFO and without dynamic AFO proved that cadence is one variable altered by the manipulation on AFO (Lam, et al., 2004 Romkes et al., 2001 Bleyenheuft et al., 2007). Lam and Romkes studies suck in shown a decrease of cadence while subject walked with dynamic AFO equation to walk with barefoot. However, in Bleyenheuft study, changes of cadence nurse a re less large contrast to others. In hinged AFO, two papers reported a increase on cadence comparison to barefoot ( Romkes et al., 2001 Tyson et al., 1998) and one shown decrease effect (Radtka et al., 2004). quaternary reviewed papers tested subjects walked with solid AFO reported decrease of cadence comparison to without solid AFO (Abel et al., 1998 Radtka et al., 2004 Lam et al., 2004 Bleyenheuft et al., 2007). Cadence in a new design AFO which use oil damper apology to restrict ankle movement also reported a decrease phenomenon on subjects walking gait with against barefoot trials. alive(p) AFO reported to have higher cadence match to solid AFO in Lam, 2004 and Bleyenheuft, 2007 studies. Meanwhile, between hinged AFO and dynamic AFO, hinged types AFO having higher cadence value ( Romkes et al., 2001). By reviewing this, an instance conclusion can be making that hinged AFO provide a high cadence. Resultant cadence variation is likely due to the design of types of the AFO. Manipulate ankle movement degree certainly influence entire locomotion trajectories, consequently cadence are involved. upperVelocity is a resultant product of stride length time cadence. Any changes of these two variables may vary walking velocity. Solid AFO, dynamic AFO, and hinged AFO were all result higher velocities and stride length compare to the condition without AFO on tested walking trials (Abel et al., 1998 Lam et al., 2004 Radtka et al., 2004 Bleyenheuft et al., 2007 Romkes et al., 2001 Fatone et al., 2009). However, a less significant increase discovered while analyzes hinged AFO and solid AFO toward barefoot condition in Fatone, 2009 and Lam, 2004 researches, respectively. From these two cases, a common observation found between them is the insignificant of stride lengths alterations.Kinematic of Gait AnalysisDF at IC (Stance Phase)Currently, AFO are design to restrict exceed ankle PF, simultaneously improve pre-positioning of the foot during IC f gait cycle. However, DF ability of AFO is strictly relying on the design and trimming pattern of particular AFO (Yokoyama et al., 2005). All types of AFO being study in this section have shown reasonable increase of DF angle compare to barefoot or without AFO condition (Abel et al., 1998 Lam et al., 2004 Radtka et al., 2004 Bleyenheuft et al., 2007 Romkes et al., 2001 Fatone et al., 2009 Yokoyama et al., 2005). This outcome is consistent with the basic functionality and characteristic of AFOs. For hinged and dynamic types, both allows free ankle DF during stance and meanwhile limit PF (Romkes et al., 2001). From review, subjects wore dynamic AFO have noticeable better DF than solid AFO and barefoot (Lam et al., 2004 Bleyenheuft et al, 2007).KF during IC (Stance phase)Knee fully extends just before heel contact and this is named as stance phase flexion. Patient walked with dynamic AFO showed significant increased in KF during initial stance compare to barefoot and there was less significant compared to solid type AFO (Lam et al., 2004 Bleyenheuft et al., 2007). Nevertheless, a slightly decreased on KF during initial contact is observed too. Both dynamic and hinged AFO shown little attenuate of KF angle compare to barefoot in Romkes, 2001 studies. In Radtka, 2005 research, the abnormal KF during barefoot walking remained although subject walk with hinged and solid AFO and this is consistent with Rethlefsen, 1999 findings.PF during TST (stance Phase)At the instance stance foot leave ground and preparing for swinging, plantar foot is flex as to push off body forwarded. Hinged AFO have impressed decreasing of PF during terminal stance if compare to walked with barefoot ( Radtka et al., 2005 Romkes et al., 2001). In Romkes, 2001 study, it revealed that hinged AFO has better push off effect compare to dynamic AFO according to their flexing ability. Besides that, in Radtka 2005s study, researchers discontinued hinged AFO has better rocker effect as to proceed swing phase compared to so lid AFO.DF during MSW (Swing Phase)DF is necessary to prevent foot drop as to provide toe clearance for patient to have better gait performance. In all the reviewed papers, DF were all increased during MSW (Abel et al., 1998 Lam et al., 2004 Radtka et al., 2004 Bleyenheuft et al., 2007 Romkes et al., 2001 Fatone et al., 2009 Yokoyama et al., 2005).Table 2. Summary on Variables Comparison of Types of AFO (ToA) with respect to Control Group Condition (CGC)Author, YearToACGCVariables comparison on ToA with respect to CGCCadenceVelocityDF at ICKF at ICPF at TSTAbel et al., 1998Fixed AFOBarefoot belittle sum up improver attachBlenyenheuft et al., 2007Dynamic AFO shoe onlyNot significant make up emergenceIncreaseprefabricated AFOShoe only strikeIncreaseIncreasedropFatone et al., 2009Hinged AFOShoe onlyNot significantNot significantIncreaseIncreaseLam et al., 2004Solid AFOBarefootDecreaseNot significantIncreaseIncreaseDecreaseDynamic AFOBarefootDecreaseIncreaseIncreaseIncreaseDecreaseRadtk a et al., 2004Solid AFOBarefootDecreaseIncreaseIncreaseDecreaseHinged AFOBarefootDecreaseIncreaseIncreaseNot significantDecreaseRomkes et al., 2001Dynamic AFOBarefootDecreaseIncreaseIncreaseDecreaseDecreaseHinged AFOBarefootIncreaseIncreaseIncreaseDecreaseDecreaseTyson, 1998Hinged AFOBarefootIncreaseIncreaseIncreaseYokoyama et al., 2005Oil damper resistance AFOShoe onlyIncreaseIncreaseIncreaseIncreaseDecreaseKinetic of human gait Ground reaction forces and Peak pressureHigh peak plantar pressure (PPP) on foot is significant in contributing ulceration and callus formation on diabetic patient (Caselli, 2002 Veyes, Murray, Buoulton, 1992). If PPP occurred on the same area for a tell period it might associated with callus or undress break down on that particular area (Boulton AJ, 1993). Incidence of skin breakdown in the forefoot chance is higher compare to in rear foot (Mueller, Zou, Lott, 2005). It has been prove in few studies that metatarsal head is the most frequent areas havin g skin injury problem rather than at heel in diabetic patient (Caselli, 2002 Sinacore, 1996).By using rocker sole in diabetic subjects, reviewed papers shown a significant PPP reduction over the high pressure area especially over forefoot and rear foot area (Albright Woodhull-Smith, 2009 Brown Wertsch, 2004 Schaff Cavanagh, 1990). Rocker sole is designed in a way that to redistribute plantar pressure from a conventional pressure dispersal to a newly designed pressure map(Brown Wertsch, 2004).Aims and ObjectivesExamine orthosis efficacy in walking gait is the foremost objective in this study. AFO is prescribing enable to make better alignment of foot on patient with pathological gait. A rocker bottom is claimed to serve better plantar pressure dissemination and as treatment to avoid further foot deformity. Basic approach in this study is to investigate the effectiveness of rocker AFO in prevent and utilize better ambulation pattern on diabetic patient from abnormal walking mech anism. Joint mobility caused by rocker AFO believed serve a better gait pattern and harmless to the connected leg segment. Rocker effect on the AFO is tending to reduce ground reaction forces to AFO user foot. Biomechanics and engineering knowledge is applied for better description.To test this hypothesis the following key objectives were undertakenTo study and enhance better gait mechanism knowledge from engineering and medical approach.To quantify and compare joint mobility with and without rocker AFO using lower limb component motion range analysis.To observe the relationship between the rocker bottom to kinetic changing on patient gait. methodologyIntroductionMethod to conduct this study is structured into few stages from recruiting subjects to conclude the study objectives. In order to keep align with this study objectives, each procedure taken has to be design carefully to reduce the possibility of data confusion and the occurrence of technical errors. Mostly, methodology to i nvestigate orthosis efficacy usually being categorized into subject accomplishment, subject assessment, AFO fabrication, AFO customize process, gait analysis laboratory testing, data acquisition and data analyzing ( Fatone et al., 2009).Subject acquirementIn this study, AFO with rocker bottom is fixed to be the interest orthosis to investigate for the entire process. From literature, an AFO rocker sole mostly applied for the purpose of offloading on diabetic patient, thus the targeted subject is diabetic patient who possess say-so to occur ulceration at plantar foot (Zimmy et al., 2004 Albright et al., 2009). 5 patients with diabetic peripheral neuropathy are recruiting as the subjects. Subject should be free from any other physical abnormality, surgery or injury on the lower limb extremities. To be prior to their participation, informed concern was acquired from all the subjects.Equipment AFO falsehoodOnly unilateral study will be carry out which means rocker AFO will be only fa bricate for either leg depends on the foot condition. Each participant will be customizing a rocker AFO which is unique with their ulceration area and foot sizes. Participants are evaluated barefoot and going through anthropometrical measurement on the modify leg by the orthotists. The AFO are custom molded by polypropylene and with a suggested 4.8 mm thick (Lam eta al., 2005). Neutral position of the AFO will be 90 at foot shank ankle. Foot length of the AFO will extended distally under the toes end and trimmed along the mediolateral butt of the foot. Upper part of the AFO will trimmed on posterior until about 2.5cm below fibula. Rocker sole flower has to be position according to subject pressure distribution. Usually subject affected areas are location with metatarsal and forefoot area. A consistent rocker sole design is purposed with the apex fall behind of the fifth metatarsal with an angle of 15. Figure 3.1 shown the rocker AFO suggestedFigure 3. Rocker AFOAfter rocker AFO finishing, subject invite to test the fitness of the AFO. If the custom made rocker AFO raises any simpleness ability issue, adjustment being done to fix it.Gait analysis laboratory testi