The impact of ankle-foot orthoses on toe clearance strategy in hemiparetic gait: a cross-sectional study.
Kannit Pongpipatpaiboon, Masahiko Mukaino, Fumihiro Matsuda and 5 others
PMID 29792211WHAT IT FOUND
Wearing their own ankle-foot orthosis increased toe clearance and reduced compensatory hip hiking in 24 people able to walk without aids after stroke.
The study reported swing-phase mechanics, not proof of fewer falls.
Key findings
01Toe clearance increased with AFO use (33.9 mm to 37.6 mm).
02Compensatory movements decreased with AFO use (33.0 to 28.1), with a significant reduction in paretic hip elevation due to pelvic obliquity (19.8 to 16.4).
03The effect did not differ significantly between thermoplastic AFOs and adjustable posterior strut AFOs, or between subacute and chronic stroke.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only people who could already walk on a treadmill without aids, handrails, or an AFO were tested, so the results may not apply to patients with severe hemiparesis. The sample was small and mixed. The study measured a short treadmill walk and only swing-phase kinematics, not falls, walking speed, endurance, community mobility, or stance-phase stability. The gait system used a simplified marker set and indirect joint angle estimates, so absolute values may not match standard full gait analysis.
The easy way to misread this
Do not read this as evidence that AFOs prevent falls or improve daily walking. The study measured only short treadmill swing-phase toe clearance and hip movement in people who could already walk without aids, and it did not assess falls, endurance, speed, or severe hemiparesis.