title: A comparison of knee-ankle-foot orthoses with either metal struts or an adjustable posterior strut in hemiplegic stroke patients.
abstract: BACKGROUND
  We investigated differences in factors affecting judgments regarding the creation of new adjustable posterior strut knee-ankle-foot orthoses (APS-KAFO) and knee-ankle-foot orthoses with metal struts (traditional KAFO) for hemiplegic stroke patients for whom KAFO were created in rehabilitation wards.
  
  
  METHODS
  Subjects were 50 patients with hemiplegia due to new-onset stroke (cerebral infarction: n = 25, cerebral hemorrhage: n = 25) who were prescribed KAFO. Patient ages ranged from 36 to 90 years, and the mean duration from stroke onset to hospitalization was 28.8 ± 13.8 days. Neurologic symptoms, cognitive function, activities of daily living, duration from hospitalization to orthosis creation, hospitalization duration, walking ability at discharge, outcome after discharge, and so forth were compared.
  
  
  RESULTS
  Fourteen patients were prescribed APS-KAFO, and 36 were prescribed traditional KAFO. Those prescribed APS-KAFO had somewhat milder neurologic symptoms and cognitive dysfunction and a shorter hospitalization duration than those prescribed traditional KAFO. Patients prescribed APS-KAFO also had a higher score and efficiency on functional independence measure at admission and discharge. Walking independence at discharge was seen in 8 of the 14 patients for whom APS-KAFO were created and 8 of the 36 patients for whom traditional KAFO were created.
  
  
  CONCLUSIONS
  APS-KAFO was chosen for patients with a high level of activity in the ward and with a higher likelihood of acquiring walking ability using APS-AFO at discharge, whereas traditional KAFO tended to be chosen for patients with relatively severe symptoms who were not expected to acquire practical walking ability.
authors.affiliation: Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan. Electronic address: shinichiromaeshima@gmail.com.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Maeshima
authors.affiliation: Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Okazaki
authors.affiliation: Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Okamoto
authors.affiliation: Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan.
authors.forename: Shiho
authors.initials: S
authors.lastname: Mizuno
authors.affiliation: Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Asano
authors.affiliation: Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Maeda
authors.affiliation: Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan.
authors.forename: Mitsuko
authors.initials: M
authors.lastname: Masaki
authors.affiliation: Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsuo
authors.affiliation: Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tsunoda
authors.affiliation: Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Sonoda
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000503:physiopathology*; D005260:Female; D061826:Foot Orthoses; D005684:Gait / Q000502:physiology*; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016138:Walking / Q000502:physiology*
keywords: Adjustable posterior strut orthoses; hemiplegia; knee-ankle-foot orthoses; stroke