Effects of ankle-foot orthosis on gait pattern and spatiotemporal indices during treadmill walking in hemiparetic stroke.
Kei Ohtsuka, Masahiko Mukaino, Junya Yamada and 6 others
PMID 37755385WHAT IT FOUND
Treadmill walking with an ankle-foot orthosis reduced forefoot contact, circumduction and contralateral vaulting in 40 people with hemiparesis after stroke, but increased excessive hip external rotation.
Only the double-stance timing asymmetry changed among timing and step measures.
Key findings
01During treadmill walking, the abnormal gait indices for forefoot contact, circumduction and contralateral vaulting were lower with an AFO.
02Excessive hip external rotation increased with an AFO from 53.7 to 62.8, while hip hiking showed only a marginal reduction.
03The absolute symmetry index of double-stance time was 21.9% without an AFO and 16.1% with an AFO, while other spatiotemporal indices did not change significantly.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
It was a retrospective study using existing hospital gait-analysis data. Participants had to be able to walk on a treadmill without an AFO or handrail, and only mild to moderate motor paresis were included, so results may not apply to more severely affected patients. The AFO types varied, including adjustable posterior strut and plastic AFOs, so the effect of any specific AFO design cannot be separated. The assessment was on a treadmill at a matched speed, not overground walking, so it may not reflect everyday walking. One abnormal gait pattern, excessive hip external rotation, increased with the AFO, so the AFO did not improve every measured pattern.
Declared interests
There are no conflicts of interest.
The easy way to misread this
Do not conclude that an AFO improves overground walking speed. The study matched treadmill speed and found little change in timing and step measures, while excessive hip external rotation increased.