title: The effect of different shoes on functional mobility and energy expenditure in post-stroke hemiplegic patients using ankle-foot orthosis.
abstract: BACKGROUND
  Ankle-foot orthoses could be utilized both with and without shoes. While several studies have shown that ankle-foot orthoses improve gait abilities in hemiplegic patients, it remains unclear whether they should be used with shoes or without.
  
  
  OBJECTIVE
  The study purpose was to compare the effect of standard shoes and rocker shoes on functional mobility in post-stroke hemiplegic patients utilizing ankle-foot orthosis.
  
  
  METHODS
  Randomized clinical study.
  
  
  METHODS
  Thirty post-stroke hemiplegic patients participated in this study randomly assigned to two groups. Group I received standard shoes + ankle-foot orthosis and group II were provided with rocker shoes + ankle-foot orthosis. Their functional mobility and energy expenditure parameters including timed up and go, timed up stairs, timed down stairs, preferred walking speed, and oxygen (O2) cost (mL/kg/m) were measured.
  
  
  RESULTS
  In group I, no significant changes were seen in outcome measures after wearing standard shoes. While in group II, O2 cost and timed up and go time significantly decreased, and preferred walking speed increased when patients wore rocker shoes. Also, there was a significant difference between rocker shoes and standard shoes in improvement of timed up and go, preferred walking speed, and O2 cost.
  
  
  CONCLUSIONS
  When patients using ankle-foot orthosis wore rocker shoes, their functional mobility improved and oxygen cost diminished. Also, rocker shoes was significantly more effective than standard shoes in improving functional mobility parameters.
  
  
  CONCLUSIONS
  This study suggests that in post-stroke hemiplegic patients using ankle-foot orthosis, wearing rocker shoes can lead to much more improved functional mobility and decreased energy expenditure compared to ankle-foot orthosis only. Thus, in stroke patients, the combination of ankle-foot orthosis-rocker shoes is recommended for both rehabilitation programs and ankle-foot orthosis efficacy investigations.
authors.affiliation: Department of Occupational Therapy, School of Rehabilitation Sciences, Hamedan University of Medical Sciences, Hamedan, Islamic Republic of Iran Department of Orthotics & Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Farzad
authors.initials: F
authors.lastname: Farmani
authors.affiliation: Iranian Research Center on Aging, Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Faculty of Allied Health, University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan mohseni_bandpei@yahoo.com.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Mohseni Bandpei
authors.affiliation: Department of Orthotics & Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Bahramizadeh
authors.affiliation: Department of Orthotics & Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Aminian
authors.affiliation: Department of Occupational Therapy, School of Rehabilitation Sciences, Hamedan University of Medical Sciences, Hamedan, Islamic Republic of Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Nikoo
authors.affiliation: Department of Physiotherapy, School of Paramedical Sciences, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Sadeghi-Goghari
mesh_terms: D000368:Aged; D004734:Energy Metabolism / Q000502:physiology*; D004867:Equipment Design; D005260:Female; D061826:Foot Orthoses; D005684:Gait / Q000502:physiology*; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012775:Shoes; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D000071939:Stroke Rehabilitation
keywords: Ankle–foot orthosis; energy expenditure; functional mobility; shoes; stroke