Using musculoskeletal modeling to evaluate the effect of ankle foot orthosis tuning on musculotendon dynamics: a case study.

This is a single case, so it describes what happened to this person and cannot show that the AFO-FC works for other people after stroke. There was no randomised comparison or control group; the conditions were evaluated in sequence over visits. The subject refused to walk with shoes alone at the first visit, so the PLS AFO was used as the comparison at that point. The subject used a quad cane with shoes alone and the PLS AFO but walked without an assistive device with the AFO-FC, so the device condition and assistive device condition differed. The AFO-FC included several components at once: a rigid non-articulated ankle set in plantar flexion, heel wedges to set the shank-to-vertical angle, and modified footwear for rollover, so the contribution of any single component cannot be separated. The retuned AFO-FC was worn full-time for one month before the final visit, so the result reflects that wearing period as well as the angle change. The unimpaired comparison group had eight subjects walking very slowly, and the subject's speed remained less than that group.

The authors declare no conflict of interest. The publication types list research support from NIH extramural and U.S. government non-PHS sources.

Do not conclude that tuning an AFO-FC to a 12° shank-to-vertical angle improves gait for people after stroke. This was a single case, and the AFO-FC also included a fixed plantar flexion angle, modified footwear, five months of full-time wear before retuning, and one month of full-time wear after retuning, so the contribution of any single component cannot be separated.