The effect of a powered ankle foot orthosis on walking in a stroke subject: a case study.
Ali Pourghasem, Ismail Ebrahimi Takamjani, Mohammad Taghi Karimi and 3 others
PMID 27942156WHAT IT FOUND
For one stroke patient, a powered ankle-foot orthosis raised ankle and hip moments and stride length, but walking speed fell.
This single case cannot show the device helps.
Key findings
01For the single stroke subject, walking speed was 9.72 m/min without an orthosis and 8.31 m/min with the powered AFO; stride length was 0.46 m without and 0.67 m with it, and cadence was 45.2 steps/min without and 24.76 steps/min with it.
02With the powered AFO, ankle moment was 0.739 Nm/BM versus 0.6 Nm/BM without it, and hip flexion moment was 0.396 Nm/BM versus 0.267 Nm/BM without it.
03The carbon AFO ankle moment was 0.975 Nm/BM, and the powered AFO ankle moment was 0.739 Nm/BM.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study reports one person, so the findings may not apply to other stroke patients. The inclusion criteria required the person to stand for at least one minute and walk at least 10 meters, so the results say little about people with more severe walking impairment. The paper does not report a control group, random allocation, or blinding, so the observed changes could be due to the testing conditions or the person's response rather than the powered AFO. The authors' discussion claims about improved walking ability are not supported by a trial in multiple patients. The powered AFO was a research device with components not necessarily available clinically.
The easy way to misread this
Do not conclude that this powered ankle-foot orthosis improves walking after stroke. It is a single case report, and the person walked more slowly with the powered orthosis than without it.