Despite frequent application of ankle-foot orthoses (AFOs), little scientific evidence is available to guide AFO-provision early after stroke. A randomized controlled trial was conducted to study the effects of AFO-provision in (sub-) acute stroke patients. Primary aim: to study effects of the actual provision of AFOs on functional outcomes. Secondary aim: to study whether the point in time at which an AFO is provided (early (week 1) or delayed (week 9)), influences these effects. Thirty-three subjects were included and walking speed, balance (Berg Balance Scale, BBS) and independence of walking (Functional Ambulation Categories, FAC) were measured. Positive effects of AFO-provision were found two weeks after provision, both when provided early (significant effects on all outcome measures) or late (BBS p = 0.011, FAC p = 0.008). Comparing the early and delayed group showed that early provision resulted in extra improvements on BBS (+5.1 points, p = 0.002) compared to late provision.

Objective 1) To study the effects of providing ankle-foot orthoses (AFOs) in subjects with (sub)acute stroke; and 2) to study whether the point in time at which an AFO is provided post-stroke (early or delayed), influences these effects. Design Randomized controlled trial. Setting Rehabilitation centre. Subjects Unilateral hemiparetic stroke subjects with indication for use of an AFO and maximal six weeks post-stroke. Interventions Subjects were randomly assigned to: early provision (at inclusion; week 1) or delayed provision (eight weeks later; week 9). Outcome measures 10-meter walk test, 6-minute walk test, Timed Up and Go Test, stairs test, Functional Ambulation Categories, Berg Balance Scale, Rivermead Mobility Index and Barthel Index; assessed in week 1, 3, 9 and 11. Results A total of 33 subjects were randomized (16 early, 17 delayed). Positive effects of AFOs were found two weeks after provision, both when provided early (significant effects on all outcomes) or delayed (Berg Balance Scale p =0.011, Functional Ambulation Categories p =0.008, 6-minute walk test p =0.005, Timed Up and Go Test p =0.028). Comparing effects after early and delayed provision showed that early provision resulted in increased levels of improvement on Berg Balance Scale (+5.1 points, p =0.002), Barthel Index (+1.9 points, p =0.002) and non-significant improvements on 10-Meter walk test (+0.14m/s, p =0.093) and Timed Up and Go Test (-5.4 sec, p =0.087), compared to delayed provision. Conclusions We found positive effects of providing AFOs in (sub)acute stroke subjects that had not used these orthoses before.