Standardization of Sizes of Knee–Ankle–Foot Orthoses (KAFO) Through Anthropometry

  • L. Narendra Nath


Lower limb orthoses enable the locomotor disabled, who have flail or weak lower limbs, to ambulate. The medical causes for these disabilities are many out of which poliomyelitis, cerebral palsy, traumatic paraplegia are common. Though, poliomyelitis is almost eradicated in underdeveloped countries, it still remains a challenge to provide orthosis to the large number of people already affected by polio in childhood. It is also to be noted that such orthosis will need replacement once in 2 years on an average. Hence, there is a huge demand for orthoses year after year. One way to address this problem is to standardize the sizes of orthosis and manufacture cost effective and durable light weight calipers. In order to standardize the sizes of orthosis, there was a need to collect anthropometric data of polio affected lower limbs in different geographical areas and their analysis to arrive at standard sizes for polio affected lower limbs. Towards this, an anthropometric device (AD) was designed and developed to collect anthropometric data of feet and knees of the patients suffering from poliomyelitis. A modular concept in Knee–Ankle–Foot Orthosis (KAFO) was developed making use of this anthropometric data. The modules of this orthosis were essentially foot plate and knee piece in standardized sizes and lateral uprights of universal size which could be cut to the required sizes depending on the length of the lower limb. The anthropometric data led to the development of seven sizes for foot plates and six sizes for knee pieces which could cater to the needs of almost all the patients. These modules of the orthosis were produced by plastic injection moulding and compression moulding processes using glass fibre reinforced polypropylene. These components could be assembled into an orthosis in less than 2 h time whereas a thermoformed KAFO used to take 6–8 h for fabrication. Also, the need to make plaster of Paris replica of polio affected limbs, as in the case of thermoformed KAFO, was done away with saving both, time and cost. The results of field trail of these standardized KAFO were encouraging and it vindicated the concept of standardization of sizes.


Fatigue Obesity Arthritis Welding Transportation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Anthropometric device


Coordinate measuring machine


Ethylene vinyl acetate


Knee–ankle–foot orthosis


Magnetic resonance imaging


Plaster of Paris





The author wishes to thank Mr. Mayank Dwivedi and Mr. K.D. Shetty for their cooperation and support throughout this work. He thanks Dr. A. Sivathanu Pillai, Dr. D. Prasada Rao, Dr.V.B.N. Prasad Rao, Mr. S.S. Chandran, and Mr. G.V. Rao for their invaluable suggestions in completing this work.


  1. Bangladesh Bureau of Statistics. Disabled population of Bangladesh, Evidence from demographic sample survey; 1987.Google Scholar
  2. Boussena M, Davies BT. Appl Ergon. 1987;18:223–8.PubMedCrossRefGoogle Scholar
  3. Brown R, Rogers N, Ward J, Wright D, Jeffries G. Biomed Sc Instr. 1995;31:235–9.Google Scholar
  4. Central Bureau of Statistics. Kenya population census-analytical report Vol. IX - Labour force; 1996.Google Scholar
  5. Churchill E, McConville JT. Technical report – Sampling and data gathering strategies for future USAF anthropometry. Wright-Patterson Air Force Base: Aerospace Medical Research Laboratory; 1976.Google Scholar
  6. Chung K, Weimar W. Technical report on spinal cord injuries (Vol. II)- Anthropometric studies for the physically disabled population. Rehabilitation Engineering Centre, University of Virginia; 1989.Google Scholar
  7. Churchill E, McConville JT. Technical report – Sampling and data gathering strategies for future USAF anthropometry. Wright-Patterson Air Force Base: Aerospace Medical Research Laboratory; 1976.Google Scholar
  8. Churchill T, Bradtmiller B, Gordon CC. Technical report – Computer software used in the U.S. army anthropometric survey. Natick: Army Natick Research, Development and Engineering Centre; 1988.Google Scholar
  9. Davis JW, Novotny R, Wasnich RD, Ross PD. Cal Tiss Int. 1999;65:100–5.CrossRefGoogle Scholar
  10. Dwivedi M, Shetty KD, Narendra Nath L. J Med Eng Technol. 2008;33:87–94.CrossRefGoogle Scholar
  11. Fessler MT, Daniel N, Afshar Y, Pinheiro IA, Bolyanatz A, Mulder MB, Cravalho M, Delgado T, Gruzd B, Correia MO, Khaltourina D, Korotayev A, Morrow J, Santiago LS, Zbarauskaite A. Archiv Sex Behav. 2005;34:267–76.CrossRefGoogle Scholar
  12. Jianfeng W, Hihara E. Euro J Appl Physiol. 2004;91:425–8.CrossRefGoogle Scholar
  13. Mahoney MJ, Mahoney KB, Rogers T, Straw MK. J Psychopathol Behav Assess. 1979;1:327–49.Google Scholar
  14. Nishimura K, Tanabe T, Kimura M, Harasawa A, Karita K, Matsushita T. J Ortho Sc. 2005;10:246–52.CrossRefGoogle Scholar
  15. Nowak E. Int J Indust Ergonom. 1992;9:109–15.CrossRefGoogle Scholar
  16. Nowak E. Int J Indust Ergonom. 1996;17:113–21.CrossRefGoogle Scholar
  17. Nowak E. Int J Industrial Ergonom. 2003;9:108–15.Google Scholar
  18. Patel SK. Internet J Epidemiol. 2009;6 (2).Google Scholar
  19. Statistics New Zealand. Disability counts; 1998.Google Scholar
  20. Tikuisis P, Meunier P, Jubenville CE. Euro J Appl Physiol. 2001;85:264–71.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of OrthopaedicsNizam’s Institute of Medical Sciences (NIMS)PunjaguttaIndia

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