Which action would be most beneficial for a patient with limited dorsiflexion in a custom AFO?

Including a dorsiflexion spring in a custom ankle-foot orthosis (AFO) for a patient with limited dorsiflexion is advantageous because it allows controlled assistance during the dorsiflexion phase of gait. A dorsiflexion spring provides a force that helps the foot move upwards when the patient starts to lift their foot during walking, effectively compensating for the muscle weakness or range of motion limitation. This addition enhances dynamic stability and helps achieve a more natural gait pattern by enabling the patient to clear the foot during swing phase and facilitating a smoother heel strike.

In contrast, integrating a solid ankle would restrict all movement at the ankle joint, which may not address the specific issue of limited dorsiflexion and could lead to further complications in mobility. Adding a plantarflexion stop could potentially limit the ankle's ability to accommodate the natural movement during walking, which may not effectively resolve the dorsiflexion limitation. Reducing ankle mobility might negatively impact the overall function of the AFO and the patient’s ability to perform daily activities, as it prevents the ankle from moving in a range necessary for effective ambulation. Hence, the inclusion of a dorsiflexion spring has clear benefits by improving gait dynamics while addressing the patient's specific needs.