Immediate effects of an individually designed functional ankle-foot orthosis on stance and gait in hemiparetic patients.
OBJECTIVE
To evaluate the immediate effects of individually designed functional in-shoe ankle-foot orthoses (AFO) made of soft and hard cast on balance, standing, and gait parameters in hemiparetic patients.


METHODS
Crossover design with randomized order of the intervention.


METHODS
A rehabilitation centre for adults with neurological disorders.


METHODS
Twenty-eight patients with hemiparesis due to stroke or traumatic brain injury.


METHODS
Postural sway, standing and gait parameters based on ground reaction forces in two conditions: Patients were randomly assigned to varying sequences of wearing AFO in footwear or wearing footwear alone.


RESULTS
AFO significantly improved weight-bearing on the affected leg (affected/ unaffected side symmetry: 2.25 +/- 1.5 with AFO versus 3.4 +/- 2.5 without AFO, P<0.05) and postural sway in stance (12.5 mm +/- 5.2 with AFO versus 15.7 mm +/- 6.7 without AFO, P < 0.05), double stance duration (21.1 +/-14.4% of gait cycle with AFO versus 25.9 +/- 21.6% of gait cycle without AFO, P < 0.05), and symmetry ratios of gait parameters such as stance duration (2.0 +/- 1.5 s with AFO versus 3.3 +/- 3.6 s without AFO, P < 0.05) and deceleration forces (1.6 +/- 0.5 with AFO versus 1.9 +/- 0.6 without AFO, P < 0.05) during gait. No significant differences were observed in all other symmetry ratios of gait parameters.


CONCLUSIONS
An individually designed functional in-shoe AFO can improve stance and gait parameters, even in a single use, in patients with hemiparesis.
Pohl
Marcus
M
Department of Early Neurological Rehabilitation, Klinik Bavaria, Kreischa, Germany. marcus.pohl@klinik-bavaria.de
Mehrholz
Jan
J
D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D005684:Gait; D006429:Hemiplegia / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D012047:Rehabilitation Centers; D012775:Shoes; D020521:Stroke / Q000150:complications