Immediate effect of different ankle-foot orthosis functions with the same dorsiflexed setting of initial ankle joint angle on walking ability in individuals with chronic stroke: a randomized crossover trial.

Only 15 participants, all from a single rehabilitation hospital in Japan. Participants were not blinded to which condition they were in, and the order was known to the person in charge on the day. Measurements were taken immediately after fitting with no habituation period, so the result reflects the first few minutes of wearing the AFO, not steady-state walking. All participants had limited ankle range of motion (several with 0° or negative passive dorsiflexion), so the AFO's ankle mobility may not have been usable in practice. The AFO was not well-fitted for all participants, and the authors note some may have been afraid of falling or not using their full ability. No kinetic or kinematic data were collected, so the mechanism behind the (or lack of) difference cannot be examined. All participants already used AFOs in daily life, which may have influenced how they walked in the test conditions. The washout period between conditions was only 10 minutes.

No funding from any public, commercial, or not-for-profit source. The authors declare no conflicts of interest.

Do not read the equivalence between the two AFO types as a general rule that any AFO with 5° initial dorsiflexion is interchangeable for all stroke patients. This was tested in 15 chronic stroke patients with limited ankle ROM, for immediate effects only, with an AFO that was not well-fitted for all participants. It does not apply to acute or subacute stroke, to patients with full ankle mobility, or to long-term use.