Clinical Efficacy of Different Ankle Foot Orthosis Design in Subjects with Foot Drop after Stroke: A Review and Comparison

Abstract

Ankle foot orthoses (AFOs) are usually used for patients with hemiplegic foot drop after stroke to provide support in walking. While the literature provides important information on the beneficial effect of the AFOs, there is still a need for more data describing the impact of different designs of AFOs on gait of subjects during rehabilitation phase after stroke. The aim of this study was to compare the clinical efficacy of two designs of AFOs (Solid and Hinged) on specific gait parameters, kinematics and kinetics during gait by subjects with hemiplegic foot drop after stroke. Thirty subjects with hemiplegic foot drop after stroke participated in this study. Comparison of gait pattern was performed in barefoot, solid and hinged AFO walking conditions. Temporal-spatial, kinematic and kinetic data were collected using force platform (version BTS P-6000, Italy) and six high definition optoelectronic cameras with reflective markers (BTS SMART-DX 6000, Italy) in gait and motion analysis lab. Though subjects walked faster, with a higher cadence and step lengths, when using solid AFO as compared to hinged AFO, the difference was non-significant (> 0.05). Significant difference was observed between gait parameters, kinematics and kinetics of either ankle foot orthosiss compared to barefoot (P < 0.05). Significant difference was observed between two AFOs in mean increase in dorsiflexion at initial contact, peak ankle dorsiflexion during stance, ankle power at push off and peak vertical ground reaction. These findings suggest that, compared to barefoot an AFO yields better gait and thus more effectively manage footdrop, however difference between uses of its variants has almost no impact. Further research to explore the potential utility of these designs of AFOs is indicated.