Powered ankle-foot orthoses: the effects of the assistance on healthy and impaired users while walking.

This is a narrative review of heterogeneous laboratory studies, not a single clinical trial, and it does not pool results or give a combined estimate. Many studies used small convenience samples, often healthy young adults, so findings may not apply to community-dwelling or more impaired patients. Devices differed in actuator, controller, weight, unilateral or bilateral use, assistance direction, and protocol, making direct comparison difficult. Some soft exosuits provided hip assistance along with ankle assistance, so effects cannot be assigned to the ankle component alone. Adaptation and steady-state effects were often not assessed, especially in elderly and impaired users, so short-term powered walking changes may not reflect long-term clinical effects. The paper does not report clinical outcomes such as falls, participation, function, or patient-reported benefit.

The supplied metadata lists non-U.S. government research support, but the article text does not provide an author conflict statement.

Do not read the reported metabolic cost reductions or gait improvements as evidence that powered ankle-foot orthoses are proven for clinical use. The review mostly summarizes small laboratory studies, many on healthy walkers, and the authors say elderly and impaired users cannot be inferred from healthy results.