The effect of a hinged ankle foot orthosis on hemiplegic gait: objective measures and users' opinions.
OBJECTIVE
To assess the effect of a hinged ankle foot orthosis (AFO) on functional mobility and gait impairments in people with a severe hemiplegia undergoing rehabilitation, and to investigate the patients' views of the hinged AFO.


METHODS
With/without group comparison, and face-to-face questionnaire.


METHODS
Twenty-five subjects over 18 years, with a hemiplegia following cerebrovascular accident (CVA) undergoing rehabilitation in a regional rehabilitation unit.


METHODS
Functional Ambulation Categories as a measure of disability. Paper walkways to measure gait impairments--stride length, step length, symmetry, cadence and velocity. Face-to-face questionnaire to determine the users' opinion of the hinged AFO.


RESULTS
Comparison of gait with and without the hinged AFO showed significant improvements in functional mobility (p = 0.000) and in some gait impairments; stride length of the weak (p < 0.005, 95% CI -8.1, -1.6) and sound legs (p < 0.014, 95% CI -8, -1), velocity (p = 0.00, 95% CI -0.1, -0.03) and cadence (p < 0.002, 95% CI -15.1, -3.8). No effect was found for step length in the weak or sound leg or symmetry. The subjects' response was positive, 24 (96%) felt they walked better with the AFO and found it comfortable. Twenty-three (92%) were unbothered by the appearance and 16 (64%) could doff and don it.


CONCLUSIONS
The hinged AFO improved objective measures of gait impairments and disability and patients were positive about it.
Centre for Research in Rehabilitation, Department of Health Studies, Brunel University, Isleworth, Middlesex, UK. sarah.tyson@brunel.ac.uk
S F
SF
Tyson
H A
HA
Thornton
D000328:Adult; D000843:Ankle Joint / Q000502:physiology*; D006233:Persons with Disabilities; D005260:Female; D020234:Gait Ataxia / Q000534:rehabilitation*; D006429:Hemiplegia / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D016138:Walking