Article

Ankle-foot orthoses are known to have a generally positive effect on
gait in stroke, however the specifc type of AFO and the time point at which it is
provided are highly variable in the currently available literature.
The objective was to determine the immediate spatiotemporal and kinematic effect
of custom-made solid ankle-foot orthoses in early stroke rehabilitation, compared
to shod walking. METHODS:
Five male and three female participants were recruited
to the study (n = 8), with a mean age of 57 (16) years who were 3.5 (3) weeks
post-stroke. Each received a custom-made solid ankle-foot orthosis to a
predefined set of design criteria and tuned using heel wedges to control the
shank inclination angle during shod walking. Repeated spatiotemporal and
three-dimensional gait measures were taken pre- and immediately
post-intervention. STUDY DESIGN: A pre-post-test experimental study. RESULTS:
With the solid ankle-foot orthosis, walking velocity increased from 0.22 (0.2) to
0.36 (0.3) m/s (p < 0.05), overall average step length increased from 0.28 (0.1)
to 0.37 (0.1) m (p < 0.05), cadence increased from 45 (19) to 56 (19) steps/min
(p < 0.05) and step length symmetry ratio increased from 0.65 (0.2) to 0.74 (0.2)
(not significant). No clear changes were observed in the joint kinematics of the
hip and knee. CONCLUSION: In our small group of early stroke patients who were
fitted with a solid ankle-foot orthosis, immediate significant improvements
occurred in walking speed, step length and cadence, when compared to walking with
shoes only. CLINICAL RELEVANCE: This study provides evidence about the immediate
effects of custom solid ankle-foot orthoses on gait of early stroke survivors.
Ankle-foot orthosis design specifications are fully described for replication.
This study suggests that observing global segment orientation may be more useful
than joint angles when fitting and tuning ankle-foot orthoses for optimal
ankle-foot orthosis/footwear alignment.
CI - (c) The International Society for Prosthetics and Orthotics 2014.

Langue : ANGLAIS