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Objective: To evaluate if the measurement of gait parameters performed in the course of an ankle-foot orthosis (AFO) fitting has a beneficial effect on the gait pattern of people affected by an acute stroke. Design: Before-after trial. Setting: Stroke orthotic clinic of a freestanding rehabilitation hospital. Participants: 8 people with hemiparesis secondary to acute stroke who were able to ambulate safely without an orthosis. Interventions: The subjects were required to walk without and then with a newly designed AFO over a 4.57m-long and 0.9m-wide GaitRite mat. The system recorded the temporospatial characteristics of gait on a portable computer. In both conditions, each subject performed three 10-m walks, with rest periods between trials. Main Outcome Measures: Velocity, cadence, and step length. Results: The mean velocity without and with an AFO was 34.84Ϯ11.11 and 46.86Ϯ12.83cm/s, respectively (F 1,7 ϭ10.95, PϽ.01); the mean cadence without and with an AFO was 53.78Ϯ8.85 and 63.01Ϯ9.24 steps/min, respectively (F 1,7 ϭ24.65, PϽ.01); the mean step length on the affected side without and with an AFO was 38.83Ϯ4.72 and 43.11Ϯ4.76cm, respectively, and the main step length on the nonaffected side was 29.31Ϯ5.98 and 36.05Ϯ6.62cm (F 1,7 ϭ6.04, PϽ.05). Conclusions: Results indicate that AFO utilization significantly improves velocity, cadence, and step length in people with acute stroke. The current study demonstrated that gait assessment can be incorporated into a clinical routine to evaluate gait improvements during an initial fitting of an AFO. This will be useful for patient education and training, justification to payers of medical necessity, monitoring progress, and decision making in weaning patients off an orthosis.

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