Relationship between anterior-posterior ground reaction force patterns and immediate effect of different types of ankle-foot orthoses in individuals with post-stroke hemiparesis: a cross-sectional study.
Yuta Chujo, Naoto Mano, Kimihiko Mori and 9 others
PMID 41578343WHAT IT FOUND
Both oil-damper and solid plastic ankle-foot orthoses improved walking speed and propulsion in people with post-stroke hemiparesis, but only in those with the most severe gait deviations.
People with better baseline gait saw no benefit, and the speed gains were small.
Key findings
01Participants were divided into three groups based on their walking force patterns: those with good propulsion, moderate impairment, and poor propulsion.
02Only the group with the poorest baseline gait (slowest speed, least propulsion) showed significant improvements in walking speed and force patterns with either type of orthosis.
03The group with the best baseline gait showed no significant changes in walking speed or propulsion with either orthosis, and the solid plastic orthosis actually reduced their propulsive force.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was cross-sectional and only examined immediate effects, so it cannot determine whether these changes lead to long-term functional improvements. The improvements in walking speed, while statistically significant in the poorest-functioning group, did not exceed the minimal detectable change threshold of 0.15 m/s, meaning they may not be clinically meaningful. 55% of participants used a T-handle cane daily, which alters ground reaction forces and makes it difficult to isolate the effect of the orthosis alone. The study included only three centers, which may limit how well the findings apply to the wider post-stroke population. The analysis focused only on sagittal plane forces, ignoring side-to-side movements and muscle activity that also affect gait.
Declared interests
The study was funded by the Japan Society for the Promotion of Science. No other conflicts of interest are reported.
The easy way to misread this
Do not interpret the statistically significant increase in walking speed for the poorest-functioning group as a clinically meaningful gain. The authors explicitly state that the changes did not exceed the minimal detectable change threshold, so the patient may not perceive a difference in daily walking.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →