Effect of Three Styles of Custom Ankle Foot Orthoses on the Gait of Stroke Patients While Walking on Level and Inclined Surfaces

In Brief The aim of this study was to provide a direct comparison of common types of AFOs used to assist stroke victims during ambulation. The study explored the effect of three types of ankle foot orthoses—solid, articulated, and posterior leaf spring—on the gait of 13 subjects with hemiparesis secondary to unilateral cerebral vascular accident. Step length, single support time, and speed were recorded using a GAITRite system on three surfaces—up incline, down decline, and a level surface. No interaction was found between surface and orthosis. Clinically no interaction indicates performance trends when walking the three surface conditions were consistent irrespective of the type of AFO worn. In general, gait under the solid ankle foot orthosis was most impaired when compared with the other orthotic conditions and shoes-only, and gait down a decline was most impaired when compared with other surfaces. Specifically, speed when walking with a solid AFO was 0.555 m/sec versus 0.627 m/sec with shoes, 0.621 m/sec with an articulated AFO, and 0.629 m/sec with a PLS AFO. Speed was 0.521 m/sec when walking down a decline, 0.590 m/sec when walking up an incline, and 0.718 m/sec when walking on a level surface. For chronic stroke patients with a functional ambulation category of four or five potential benefits of an orthosis other than solid ankle should be kept in mind when recommending an ankle foot orthosis for use in rehabilitation. The aim of this study was to provide a direct comparison of three common types of AFOs—solid, articulated, and posterior leaf spring—used to assist stroke victims during ambulation. For the 13 subjects with hemiparesis secondary to unilateral cerebral vascular accident, the solid AFO was shown to result in the most compromised gait when considering speed, step length, and single support time. For chronic stroke patients with a functional ambulation category of 4 or 5, potential benefits of an orthosis other than solid ankle should be kept in mind when recommending an AFO for use in rehabilitation.