title: Effects of ankle-foot orthoses on mediolateral foot-placement ability during post-stroke gait.
abstract: BACKGROUND
  Accurate and precise mediolateral foot placement is important for balance during gait, but is impaired post stroke. Mediolateral foot placement may be improved with ankle-foot orthosis use.
  
  
  OBJECTIVE
  The purpose of this study was to determine whether an ankle-foot orthosis improves mediolateral foot-placement ability during post-stroke ambulation.
  
  
  METHODS
  Crossover trial with randomized order of conditions tested.
  
  
  METHODS
  The accuracy and precision of mediolateral foot placement was quantified while subjects targeted four different randomized step widths. Subjects were tested with and without their regular non-rigid ankle-foot orthosis in two separate visits (order randomized).
  
  
  RESULTS
  While ankle-foot orthosis use corrected foot and ankle alignment (i.e. significantly decreased mid-swing plantar flexion, p = 0.000), effects of ankle-foot orthosis use on hip hiking (p = 0.545), circumduction (p = 0.179), coronal plane hip range of motion (p = 0.06), and mediolateral foot-placement ability (p = 0.537) were not significant.
  
  
  CONCLUSIONS
  While ankle-foot orthosis-mediated equinovarus correction of the affected foot and ankle was not associated with improved biomechanics of walking (i.e. proximal ipsilateral hip kinematics or mediolateral foot-placement ability), it may affect other aspects of balance that were not tested in this study (e.g. proprioception, cerebellar, vestibular, and cognitive mechanisms).
  
  
  CONCLUSIONS
  Studies that investigate the effect of ankle-foot orthosis on gait can help advance stroke rehabilitation by documenting the specific gait benefits of ankle-foot orthosis use. In this study, we investigated the effect of ankle-foot orthosis use on mediolateral foot-placement ability, an aspect of gait important for maintaining balance.
authors.affiliation: Prosthetics-Orthotics Center, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, USA Department of Biomedical Engineering, Northwestern University, Evanston, USA kikiz@u.northwestern.edu.
authors.forename: Angelika
authors.initials: A
authors.lastname: Zissimopoulos
authors.affiliation: Prosthetics-Orthotics Center, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, USA Jesse Brown VA Medical Center, Department of Veterans Affairs, Chicago, USA.
authors.forename: Stefania
authors.initials: S
authors.lastname: Fatone
authors.affiliation: Prosthetics-Orthotics Center, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, USA Jesse Brown VA Medical Center, Department of Veterans Affairs, Chicago, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Gard
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D005528:Foot / Q000503:physiopathology*; D061826:Foot Orthoses; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D000071939:Stroke Rehabilitation
keywords: Orthotic devices; biomechanics; gait; kinematics; stroke