title: Effects of ankle-foot orthoses on functional recovery after stroke: a propensity score analysis based on Japan rehabilitation database.
abstract: OBJECTIVE
  The purpose of the present study was to investigate potential effects of ankle-foot orthoses (AFOs) on the functional recovery of post-acute stroke patients following rehabilitation.
  
  
  METHODS
  This study is a retrospective cohort study. Participants were in-hospital stroke patients registered in the Japan Rehabilitation Database between 2005 and 2012. A total of 1862 patients were eligible after applying exclusion criteria. Propensity score analysis was applied to adjust for potential bias and to create two comparable groups. An additional subset analysis focused on Functional Independence Measure (FIM) scores on admission.
  
  
  RESULTS
  In this sample, 30.7% of 1863 eligible patients were prescribed AFOs. Propensity score matched analysis showed that patients with AFOs had significantly higher scores than those without them for discharge FIM (mean: 91.3 vs 85.8; p=0.02), FIM gain (mean: 28.9 vs 23.5; p<0.001), and FIM efficiency (mean: 0.27 vs 0.22; p<0.001). Inverse probability weighting analysis showed similar results. In the subset analysis, patients with AFOs had significantly higher discharge FIM compared with those without them in the low admission FIM subgroup only. In addition, patients with AFOs performed independent exercise more than those without them (p<0.001).
  
  
  CONCLUSIONS
  These data suggest that stroke survivors may have better functional recovery if they are prescribed an AFO than if they are not prescribed an AFO. The use of AFOs is considered to be a feasible option to improve functional recovery of stroke rehabilitation patients.
authors.affiliation: Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Momosaki
authors.affiliation: Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Abo
authors.affiliation: Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Kakuda
authors.affiliation: Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamada
authors.affiliation: Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Kinoshita
mesh_terms: D015331:Cohort Studies; D019992:Databases as Topic; D061826:Foot Orthoses / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D057216:Propensity Score; D012189:Retrospective Studies; D020521:Stroke / Q000473:pathology; D000071939:Stroke Rehabilitation
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