Effect of Custom Dynamic Orthoses on Forefoot Loading

Patient Inclusion criteria * Ages: 18-65 * Sustained a function limiting injury below the knee, requiring a carbon fiber custom dynamic orthosis * Shoe size between women's 8 and 13.5 or men's 6.5 and 13 * Any of the following: weakness of ankle plantarflexors (\<4/5 on MMT), limited pain free ankle motion (DF\<10deg or PF\<20deg), mechanical pain with loading onto hindfoot/midfoot/forefoot (\>4/10 on verbal numeric pain rating scale), ankle or hindfoot fusion, candidate for ankle or hindfoot fusion, candidate for amputation secondary to ankle/foot impairment * Ability to walk 25 feet without using a cane or crutch * Ability to walk at a slow to moderate pace * Able to read and write in English and provide written informed consent Patient Exclusion criteria * Pain \> 9/10 while walking * Ankle weakness as a result of spinal cord injury or central nervous system pathology * AFO or CDO prescription that includes a knee brace or goes up to thigh * Medical or psychological conditions that would preclude functional testing (ex. severe traumatic brain injury, heart condition, clotting disorder, lung condition, stroke, vestibular disorder) * Nerve, muscle, bone, or other condition limiting function of the contralateral extremity * BMI greater than 40 * Visual or hearing impairment that limit walking ability or limit the ability to comply with instructions given during testing * Pregnancy