Customized passive-dynamic ankle-foot orthoses can improve walking economy and speed for many individuals post-stroke.
J Neuroeng Rehabil
; 21(1): 126, 2024 Jul 29.
Article
in En
| MEDLINE
| ID: mdl-39069629
ABSTRACT
BACKGROUND:
Passive-dynamic ankle-foot orthoses (PD-AFOs) are often prescribed to address plantar flexor weakness during gait, which is commonly observed after stroke. However, limited evidence is available to inform the prescription guidelines of PD-AFO bending stiffness. This study assessed the extent to which PD-AFOs customized to match an individual's level of plantar flexor weakness influence walking function, as compared to No AFO and their standard of care (SOC) AFO.METHODS:
Mechanical cost-of-transport, self-selected walking speed, and key biomechanical variables were measured while individuals greater than six months post-stroke walked with No AFO, with their SOC AFO, and with a stiffness-customized PD-AFO. Outcomes were compared across these conditions using a repeated measures ANOVA or Friedman test (depending on normality) for group-level analysis and simulation modeling analysis for individual-level analysis.RESULTS:
Twenty participants completed study activities. Mechanical cost-of-transport and self-selected walking speed improved with the stiffness-customized PD-AFOs compared to No AFO and SOC AFO. However, this did not result in a consistent improvement in other biomechanical variables toward typical values. In line with the heterogeneous nature of the post-stroke population, the response to the PD-AFO was highly variable.CONCLUSIONS:
Stiffness-customized PD-AFOs can improve the mechanical cost-of-transport and self-selected walking speed in many individuals post-stroke, as compared to No AFO and participants' standard of care AFO. This work provides initial efficacy data for stiffness-customized PD-AFOs in individuals post-stroke and lays the foundation for future studies to enable consistently effective prescription of PD-AFOs for patients post-stroke in clinical practice. TRIAL REGISTRATION NCT04619043.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Foot Orthoses
/
Walking Speed
/
Stroke Rehabilitation
Limits:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
J Neuroeng Rehabil
Journal subject:
ENGENHARIA BIOMEDICA
/
NEUROLOGIA
/
REABILITACAO
Year:
2024
Document type:
Article
Affiliation country: