title: Comparative analysis and quantitative evaluation of ankle-foot orthoses for foot drop in chronic hemiparetic patients.
abstract: BACKGROUND
  Ankle-foot-orthoses (AFOs) are frequently prescribed for hemiparetic patients to compensate for the foot drop syndrome. However, there is not a systematic study either on the effectiveness of AFOs in the gait recovery process or pointing out the therapeutic differences among the various types of AFOs available on the market.
  
  
  OBJECTIVE
  To perform a comparative evaluation of solid and dynamic Ankle-Foot-Orthoses (AFOs) on hemiparetic patients affected by foot drop syndrome by means of spatio-temporal, kinematic and electromyographic indicators.
  
  
  METHODS
  Crossover design with randomization for the interventions.
  
  
  METHODS
  A rehabilitation center for adults with neurologic disorders.
  
  
  METHODS
  Ten chronic hemiparetic patients with foot drop syndrome met inclusion criteria and volunteered to participate.
  
  
  METHODS
  Biomechanical gait analysis was carried out on hemiparetic subjects with foot drop syndrome under 3 conditions with randomized sequences: 1) without AFO; 2) wearing a solid AFO; 3) wearing a dynamic AFO. Significant changes in spatio-temporal, kinematic and electromyographic features of gait were investigated.
  
  
  RESULTS
  Gait analysis outcomes showed that there were no significant differences among the solid and the dynamic AFO on the spatio-temporal parameters. Both AFOs led to a reduction of the range of motion of the ankle dorsi-plantar-flexion during stance with respect to the ambulation without AFO. They also had the effect of reducing the asymmetry between the paretic and the contralateral limb in terms of ankle angle at initial contact and hip flexion. The solid AFO generally led to an increase of the co-contraction of the couples of muscles involved in the gait.
  
  
  CONCLUSIONS
  The proposed set of indicators showed that the AFOs were capable of limiting the effect of the foot-drop in hemiparetic patients and balancing the two limbs. Main differences between the two orthoses were related to muscular activity, being the level of co-contraction of the two couples of analysed muscles typically lower when the dynamic AFO was worn and closer to a normal pattern.
  
  
  CONCLUSIONS
  A more extensive use of the proposed indicators in the clinical practice is expected in order to enable the definition of clinical guidelines for the prescription of the two devices.
authors.affiliation: Laboratory of Biomedical Robotics and Biomicrosystems, Università Campus Bio‑Medico, Rome, Italy - l.zollo@unicampus.it.
authors.forename: L
authors.initials: L
authors.lastname: Zollo
authors.forename: N
authors.initials: N
authors.lastname: Zaccheddu
authors.forename: A L
authors.initials: AL
authors.lastname: Ciancio
authors.forename: M
authors.initials: M
authors.lastname: Morrone
authors.forename: M
authors.initials: M
authors.lastname: Bravi
authors.forename: F
authors.initials: F
authors.lastname: Santacaterina
authors.forename: M
authors.initials: M
authors.lastname: Laineri Milazzo
authors.forename: E
authors.initials: E
authors.lastname: Guglielmelli
authors.forename: S
authors.initials: S
authors.lastname: Sterzi
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D018592:Cross-Over Studies; D004576:Electromyography; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D005260:Female; D005528:Foot / Q000503:physiopathology; D061826:Foot Orthoses; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000150:complications / Q000209:etiology / Q000534:rehabilitation*; D016059:Range of Motion, Articular / Q000502:physiology*; D012047:Rehabilitation Centers; D062211:Spatio-Temporal Analysis; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation