Background: Ankle–foot orthoses (AFOs) are commonly prescribed to support lower limb function in individuals with neuromuscular or musculoskeletal impairments. While traditionally fabricated custom AFOs remain the standard of care, the adoption of 3D printing has emerged as a promising alternative manufacturing process, offering potential benefits in design flexibility, process efficiency, and patient-centered customization. However, clinical evidence evaluating patient satisfaction with 3D-printed AFOs remains limited. Objectives: The primary objective of this study was to evaluate and compare patient satisfaction with 3D-printed versus traditionally fabricated custom AFOs using a standardized satisfaction questionnaire. A secondary objective was to assess patients' preference of their device after a 3-month wear period. Study Design: A single-group crossover study was conducted as a program evaluation within a private orthotic clinic. Methods: Fifty-six patients were recruited, with 29 completing the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) surveys. Participants received both traditionally fabricated and 3D-printed AFOs. Each device was worn for a period of 2 weeks. QUEST 2.0 satisfaction data were collected after each 2-week wear period for both devices. At the 3-month mark, participants were asked to indicate their preferred device. Statistical comparisons were performed using a Wilcoxon signed rank test. Participant comments were analyzed using a hybrid content and thematic analysis approach. Results: Mean patient satisfaction scores for both device types were high (traditional: 4.41 ± 0.30; 3D printed: 4.47 ± 0.23) out of a possible 5 points. No statistically significant differences were found in overall satisfaction for the original and extended QUEST surveys ( P = 0.472 and P = 0.222); however, individual items showed statistically significant differences in favor of the 3D-printed AFOs for weight ( P = 0.001) and in favor of the traditionally fabricated AFOs for durability ( P = 0.039). At the 3-month follow-up, 61% of participants preferred their 3D-printed device, 22% preferred the traditional AFO, and 17% had no preference. Conclusions: This study demonstrates that 3D-printed AFOs are a clinically viable alternative to traditional fabrication with comparable overall patient satisfaction. These findings support the broader integration of digital workflows in orthotic and prosthetic care, while highlighting the importance of continued research into long-term outcomes. Clinical Relevance Statement: The field of orthotics and prosthetics is undergoing a significant technological shift toward digital workflows and 3D printing, yet patient satisfaction with these emerging fabrication methods has remained largely unexamined. This study provides foundational evidence that 3D-printed AFOs are well-received by patients, offering critical insight to guide the future of integrating 3D printing into clinical orthotic practice. ( J Prosthet Orthot . 2026;X:XX–XX)
Burton et al. (Mon,) studied this question.