Role of ankle foot orthosis in improving locomotion and functional recovery in patients with stroke: A prospective rehabilitation study

Abstract

Objective:To study role of ankle foot orthosis (AFO) in improving locomotion and functional recovery after stroke.Setting:Neurological Rehabilitation Department of a university research tertiary hospital.Patients and Methods:AFO and activity based rehabilitation.Main Outcome Measures:Distance (meters) covered during the 6-minute walk test (6MWT) and speed (meter/second) during the 10-meter walk test. Functional abilities assessed using Functional Independence Measure (FIM®).Results:Twenty-six patients (21 male) with stroke (mean duration 196.7 days, range 45–360 days) and mean age of 41.6 years (range 18–65 years, standard deviation [SD] 12.5) were included. Fourteen had right hemiplegia. The mean length of stay in the unit was 26.5 days (range 18–45 days, SD 5.5). All patients had equinus deformity with spastic foot drop and were provided with AFO. Walking endurance with 6MWT was 90 m on admission (without AFO). At discharge, it improved to 174 m with AFO and 121 m without AFOs (P < 0.001-with and without AFO at discharge). Walking speed improved from 0.4 m/s (admission) to 0.51 m/s with AFO, P = 0.004 and 0.45 m/s without AFO, P = 0.015) at discharge. Nine patients (34.6%) had clinically important difference-minimal clinically important difference (>0.16 m/s speed gain; >50 m endurance gain) at discharge. The mean FIM® score on admission was 84.3 ± 18.6. At discharge FIM® improved to 101.9 ± 13.7 (P < 0.001).Conclusions:Use of AFOs improve gait parameters significantly in only one-third stroke patients in the study when combined with activity-based inpatient-rehabilitation.

Effect of Kinesio Taping on the Walking Ability of Patients with Foot Drop after Stroke

“…During the operation of functional taping, a large pulling force is applied to the taping which may be similar to the AFO that promotes the improvement of walking and balance function [33]. Previous studies have demonstrated that the use of AFO is conducive to the normal posture of stroke patients in the normal movement pattern during training through the accumulation of feedback for positive reinforcement to establish the correct body pattern [34]. In this study, kinesio taping could produce an immediate effect on correcting the position of the ankle, increasing the walking efficiency, and improving the walking function, which may assist with the development of related rehabilitation training.…”

A novel hinged ankle foot orthosis for gait performance in chronic hemiplegic stroke survivors: a feasibility study

“…AFO use is suggested to overcome such problem. Sankaranarayan et al [21] conducted a study of the gait of 26 stroke survivors with spasticity who applied AFOs. The study findings showed that using an AFO could positively influence the walking speed of hemiplegic stroke survivors.…”

Rehabilitacija osoba nakon moždanog udara

“…Ukoliko bolesnik može sjediti, ruka se oslanja na stol u položaju antefleksije u ramenu od 90° i fleksije u laktu od 90° uz podlakticu u srednjem položaju između supinacije i pronacije s cilindričnim objektom u šaci 26 . Korištenje ortoze za gležanj i stopalo može umanjiti rizik od kontrakture stopala u plantarnoj fleksiji uz poboljšanje biomehanike hoda 27 . U kasnijem tijeku razvoj kontrakture zglobova povezan je sa stupnjem spasticiteta, bolom i smanjenom funkcionalnosti ekstremiteta.…”