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Prosthet Orthot Int. 2015 Oct;39(5):372-9. doi: 10.1177/0309364614534294. Epub 2014 May 30.

Effects of ankle-foot orthoses on mediolateral foot-placement ability during post-stroke gait.

Author information

1
Prosthetics-Orthotics Center, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, USA Department of Biomedical Engineering, Northwestern University, Evanston, USA kikiz@u.northwestern.edu.
2
Prosthetics-Orthotics Center, Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, USA Jesse Brown VA Medical Center, Department of Veterans Affairs, Chicago, USA.

Abstract

BACKGROUND:

Accurate and precise mediolateral foot placement is important for balance during gait, but is impaired post stroke. Mediolateral foot placement may be improved with ankle-foot orthosis use.

OBJECTIVE:

The purpose of this study was to determine whether an ankle-foot orthosis improves mediolateral foot-placement ability during post-stroke ambulation.

STUDY DESIGN:

Crossover trial with randomized order of conditions tested.

METHODS:

The accuracy and precision of mediolateral foot placement was quantified while subjects targeted four different randomized step widths. Subjects were tested with and without their regular non-rigid ankle-foot orthosis in two separate visits (order randomized).

RESULTS:

While ankle-foot orthosis use corrected foot and ankle alignment (i.e. significantly decreased mid-swing plantar flexion, p = 0.000), effects of ankle-foot orthosis use on hip hiking (p = 0.545), circumduction (p = 0.179), coronal plane hip range of motion (p = 0.06), and mediolateral foot-placement ability (p = 0.537) were not significant.

CONCLUSION:

While ankle-foot orthosis-mediated equinovarus correction of the affected foot and ankle was not associated with improved biomechanics of walking (i.e. proximal ipsilateral hip kinematics or mediolateral foot-placement ability), it may affect other aspects of balance that were not tested in this study (e.g. proprioception, cerebellar, vestibular, and cognitive mechanisms).

CLINICAL RELEVANCE:

Studies that investigate the effect of ankle-foot orthosis on gait can help advance stroke rehabilitation by documenting the specific gait benefits of ankle-foot orthosis use. In this study, we investigated the effect of ankle-foot orthosis use on mediolateral foot-placement ability, an aspect of gait important for maintaining balance.

KEYWORDS:

Orthotic devices; biomechanics; gait; kinematics; stroke

PMID:
24878846
DOI:
10.1177/0309364614534294
[Indexed for MEDLINE]

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