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However, the physical human-robot interface (HRi) has not been properly addressed. Current orthoses lead to spurious forces at the HRi that cause adverse effects and high abandonment rates. This study aims to assess and compare, in a holistic approach, human-robot joint misalignment and gait kinematics in three fixation designs of ankle-foot orthoses (AFOs). These are AFOs with a frontal shin guard (F-AFO), lateral shin guard (L-AFO), and the ankle modulus of the H2 exoskeleton (H2-AFO). An experimental protocol was implemented to assess misalignment, fixation displacement, pressure interactions, user-perceived comfort, and gait kinematics during walking with the three AFOs. The F-AFO showed reduced vertical misalignment (peak of 1.37 \u00b1 0.90 cm, p-value &lt; 0.05), interactions (median pressures of 0.39\u20133.12 kPa), and higher user-perceived comfort (p-value &lt; 0.05) when compared to H2-AFO (peak misalignment of 2.95 \u00b1 0.64 and pressures ranging from 3.19 to 19.78 kPa). F-AFO also improves the L-AFO in pressure (median pressures ranging from 8.64 to 10.83 kPa) and comfort (p-value &lt; 0.05). All AFOs significantly modified hip joint angle regarding control gait (p-value &lt; 0.01), while the H2-AFO also affected knee joint angle (p-value &lt; 0.01) and gait spatiotemporal parameters (p-value &lt; 0.05). Overall, findings indicate that an AFO with a frontal shin guard and a sports shoe is effective at reducing misalignment and pressure at the HRI, increasing comfort with slight changes in gait kinematics.<\/jats:p>","DOI":"10.3390\/s24010246","type":"journal-article","created":{"date-parts":[[2023,12,31]],"date-time":"2023-12-31T10:01:06Z","timestamp":1704016866000},"page":"246","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Human-Robot Joint Misalignment, Physical Interaction, and Gait Kinematic Assessment in Ankle-Foot Orthoses"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5918-2264","authenticated-orcid":false,"given":"Ricardo Lu\u00eds","family":"Andrade","sequence":"first","affiliation":[{"name":"Center for MicroElectroMechanical Systems (CMEMS), University of Minho, 4800-058 Guimar\u00e3es, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9547-3051","authenticated-orcid":false,"given":"Joana","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"Center for MicroElectroMechanical Systems (CMEMS), University of Minho, 4800-058 Guimar\u00e3es, Portugal"},{"name":"LABBELS\u2014Associate Laboratory, 4710-057 Braga\/4800-058 Guimar\u00e3es, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4885-4924","authenticated-orcid":false,"given":"Pedro","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Porto Biomechanics Laboratory (LABIOMEP), University of Porto, 4200-450 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4109-2939","authenticated-orcid":false,"given":"Jo\u00e3o P.","family":"Vilas-Boas","sequence":"additional","affiliation":[{"name":"Porto Biomechanics Laboratory (LABIOMEP), University of Porto, 4200-450 Porto, Portugal"},{"name":"Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7056-4555","authenticated-orcid":false,"given":"Miguel T.","family":"Silva","sequence":"additional","affiliation":[{"name":"IDMEC, Instituto Superior T\u00e9cnico, Universidade de Lisboa, Av. Rovisco Pais 1, 1049-001 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0023-7203","authenticated-orcid":false,"given":"Cristina P.","family":"Santos","sequence":"additional","affiliation":[{"name":"Center for MicroElectroMechanical Systems (CMEMS), University of Minho, 4800-058 Guimar\u00e3es, Portugal"},{"name":"LABBELS\u2014Associate Laboratory, 4710-057 Braga\/4800-058 Guimar\u00e3es, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.2147\/NDT.S114102","article-title":"Robot-assisted gait training for stroke patients: Current state of the art and perspectives of robotics","volume":"13","author":"Morone","year":"2017","journal-title":"Neuropsychiatr. Dis. 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