Article

OBJECTIVE: To study the six-month clinical effects of providing ankle-foot
orthoses at different moments (early or delayed) in (sub)acute stroke; this is a
follow-up to a published trial. DESIGN: Randomized controlled trial. SETTING:
Rehabilitation centre. SUBJECTS: Unilateral hemiparetic stroke subjects maximal
six weeks post-stroke with indication for ankle-foot orthosis use. INTERVENTIONS:
Subjects were randomly assigned to early (at inclusion; week 1) or delayed
provision (eight weeks later; week 9). OUTCOME MEASURES: Functional tests
assessing balance and mobility were performed bi-weekly for 17 weeks and at week
26. RESULTS: In all, 33 subjects were randomized. No differences at week 26 were
found between both groups for any of the outcome measures. However, results
suggest that early provision leads to better outcomes in the first 11-13 weeks.
Berg Balance Scale ( P = 0.006), Functional Ambulation Categories ( P = 0.033)
and 6-minute walk test ( P < 0.001) showed significantly different patterns over
time. Clinically relevant but statistically non-significant differences of 4-10
weeks in reaching independent walking with higher balance levels were found,
favouring early provision. CONCLUSION: No six-month differences in functional
outcomes of providing ankle-foot orthoses at different moments in the early
rehabilitation after stroke were found. Results suggest that there is a period of
11-13 weeks in which early provision may be beneficial, possibly resulting in
early independent and safe walking. However, our study was underpowered. Further
research including larger numbers of subjects is warranted.

Langue : ANGLAIS