Comparison between a novel helical and a posterior ankle-foot orthosis on gait in people with unilateral foot drop: a randomised crossover trial.
David Gasq, Raphaël Dumas, Benoit Caussé and 4 others
PMID 37170277WHAT IT FOUND
In people with peripheral neuropathy or neuromuscular disease, a new helical carbon ankle-foot orthosis increased walking distance and improved mobility more than a standard posterior leaf spring AFO.
Participants were also significantly more satisfied with the helical design.
Key findings
01Walking distance on the 6-minute walk test was significantly greater with the helical AFO than with the posterior leaf spring AFO.
02Timed Up and Go performance time was significantly shorter (better) with the helical AFO compared to the posterior leaf spring AFO.
03Participants reported significantly higher satisfaction with the device features of the helical AFO compared to the posterior leaf spring AFO.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was small (20 participants), and the 3D gait analysis data was available for only 15 participants, reducing statistical power for biomechanical outcomes. Participants and evaluators were not blinded, which could introduce bias, particularly in satisfaction ratings and potentially in functional test performance. The crossover design involved a one-week period per condition; it is unknown if this is sufficient time for full accommodation to a new orthosis. The study included a heterogeneous group of etiologies (peripheral neuropathy and NMD), which may limit generalizability to specific subgroups. Gait speed was fixed during 3D analysis to match the no-AFO condition, which prevented the assessment of the orthoses' effect on propulsion at spontaneous speeds.
Declared interests
One of the authors (BC) designed and developed the helical AFO. The hAFO is manufactured by InnovPulse. The orthotist who fabricated the devices was independent and not employed by InnovPulse.
The easy way to misread this
Do not assume the helical AFO is superior for all foot drop populations. The study specifically recruited individuals with peripheral neuropathy or neuromuscular disease without spasticity. The results may not apply to patients with central neurological disorders like stroke, who often require more rigid orthoses to manage spasticity.