Article

Timely provision of an ankle-foot orthosis (AFO) orthotist customized
for individuals early after stroke can be problematic.
OBJECTIVE: To evaluate the
efficacy of a therapist-made AFO (SWIFT Cast) for walking recovery. METHODS: This
was a randomized controlled, observer-blind trial. Participants (n = 105) were
recruited 3 to 42 days poststroke. All received conventional physical therapy
(CPT) that included use of "off-the-shelf" and orthotist-made AFOs. People
allocated to the experimental group also received a SWIFT Cast for up to 6 weeks.
Measures were undertaken before randomization, 6 weeks thereafter (outcome), and
at 6 months after stroke (follow-up). The primary measure was walking speed.
Clinical efficacy evaluation used analysis of covariance. RESULTS: Use of a SWIFT
Cast during CPT sessions was significantly higher (P < .001) for the SWIFT Cast
(55%) than the CPT group (3%). The CPT group used an AFO in 26% of CPT sessions,
compared with 11% for the SWIFT Cast group (P = .005).
At outcome, walking speed
was 0.42 (standard deviation [SD] = 0.37) m/s for the CPT group and 0.32 (SD =
0.34) m/s for the SWIFT Cast group. Follow-up walking speed was 0.53 (SD = 0.38)
m/s for the CPT group and 0.43 (0.34) m/s for the SWIFT Cast group. Differences,
after accounting for minimization factors, were insignificant at outcome (P =
.345) and follow-up (P = .360). CONCLUSION AND IMPLICATIONS:
SWIFT Cast did not
enhance the benefit of CPT, but the control group had greater use of another AFO.
However, SWIFT Cast remains a clinical option because it is low cost and
custom-made by therapists who can readily adapt it during the rehabilitation period.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS