Ankle-foot Orthosis With an Oil Damper Versus Nonarticulated Ankle-foot Orthosis in the Gait of Patients With Subacute Stroke: A Randomized Controlled Trial

Abstract BackgroundGait improvement in patients with stroke using ankle-foot orthosis (AFO) has been compared to the effects of non-AFO use in previous studies, but the effect of different kinds of AFOs has not been clear. When considering the effect of different kinds of AFOs on gait, the dorsiflexion and plantar flexion moment of resistance is considered a key determinant of functional effect. In this study, the effect on gait of using an AFO with an oil damper (AFO-OD), which has plantar flexion resistance but no dorsiflexion resistance, and a nonarticulated AFO, which has both dorsiflexion and plantar flexion resistance, were compared in a randomized controlled trial. MethodsForty-one patients (31 men, 10 women; mean age 58.4 ± 11.3 years) in the subacute phase of stroke were randomly allocated to two groups to undergo 2 weeks of gait training by physiotherapists while wearing an AFO-OD or a nonarticulated AFO. A motion capture system was utilized to measure shod gait without orthosis at baseline and after training with the allocated AFO. Data analysis was performed focused on the spatial and temporal parameters, ground reaction force, shank-to-vertical angle, and ankle joint kinematics and kinetics. Two-way mixed ANOVA was performed to clarify the effect of AFO use and the difference between the two AFOs. ResultsThirty-six patients completed the study (17 in the AFO-OD group and 19 in the nonarticulated AFO group). Spatial and temporal parameters and ankle joint kinematics were improved after 2 weeks in both AFO groups. Interactions were found for the range of shank-to-vertical angles in paretic single stance and ankle peak power absorption. In the AFO-OD group, both parameters improved when the participants walked with the AFO compared to the shod gait, but there was no change in the nonarticulated AFO group. Power generation was not increased in either AFO group. ConclusionsThe results of this study showed that AFO with plantar flexion resistance but without dorsiflexion resistance improved the range of the shank-to-vertical angle and ankle power absorption but not power generation in a paretic stance. (336/350 words)Trial registration: UMIN000028126 Registered 1 August 2017,https://upload.umin.ac.jp/cgi-bin/icdr/ctr_menu_form_reg.cgi?recptno=R000032197

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Effect of 3D Printing Individualized Ankle-Foot Orthosis on Plantar Biomechanics and Pain in Patients with Plantar Fasciitis: A Randomized Controlled Trial

Medical Science Monitor ◽

10.12659/msm.915045 ◽

2019 ◽

Vol 25 ◽

pp. 1392-1400 ◽

Cited By ~ 5

Author(s):

Rui Xu ◽

Zhonghan Wang ◽

Tingjian Ma ◽

Zhenxiao Ren ◽

Hui Jin

Keyword(s):

Randomized Controlled Trial ◽

3D Printing ◽

Plantar Fasciitis ◽

Controlled Trial ◽

Ankle Foot Orthosis ◽

Randomized Controlled ◽

Foot Orthosis

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Early or delayed provision of an ankle-foot orthosis in patients with acute and subacute stroke: a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215516658337 ◽

2016 ◽

Vol 31 (6) ◽

pp. 798-808 ◽

Cited By ~ 6

Author(s):

Corien DM Nikamp ◽

Jaap H Buurke ◽

Job van der Palen ◽

Hermie J Hermens ◽

Johan S Rietman

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Ankle Foot Orthosis ◽

Randomized Controlled ◽

Subacute Stroke ◽

Foot Orthosis

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The effect of an ankle-foot orthosis on walking ability in chronic stroke patients: a randomized controlled trial

Clinical Rehabilitation ◽

10.1191/0269215504cr770oa ◽

2004 ◽

Vol 18 (5) ◽

pp. 550-557 ◽

Cited By ~ 111

Author(s):

D CM de Wit ◽

J H Buurke ◽

J MM Nijlant ◽

M J IJzerman ◽

H J Hermens

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Chronic Stroke ◽

Walking Ability ◽

Stroke Patients ◽

Ankle Foot Orthosis ◽

Randomized Controlled ◽

Foot Orthosis

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Six-month effects of early or delayed provision of an ankle-foot orthosis in patients with (sub)acute stroke: a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215517709052 ◽

2017 ◽

Vol 31 (12) ◽

pp. 1616-1624 ◽

Cited By ~ 4

Author(s):

Corien DM Nikamp ◽

Jaap H Buurke ◽

Job van der Palen ◽

Hermie J Hermens ◽

Johan S Rietman

Keyword(s):

Randomized Controlled Trial ◽

Acute Stroke ◽

Controlled Trial ◽

Ankle Foot Orthosis ◽

Randomized Controlled ◽

Foot Orthosis

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Comparison of ankle–foot orthoses with plantar flexion stop and plantar flexion resistance in the gait of stroke patients: A randomized controlled trial

Prosthetics and Orthotics International ◽

10.1177/0309364618774055 ◽

2018 ◽

Vol 42 (5) ◽

pp. 544-553 ◽

Cited By ~ 7

Author(s):

Sumiko Yamamoto ◽

Souji Tanaka ◽

Naoyuki Motojima

Keyword(s):

Controlled Trial ◽

Plantar Flexion ◽

Upper Body ◽

Foot Orthoses ◽

Stroke Patients ◽

Subacute Phase ◽

Ankle Foot Orthosis ◽

Randomized Controlled ◽

Ankle Foot Orthoses ◽

Foot Orthosis

Background: The effect of plantar flexion resistance of ankle–foot orthoses on the ankle and knee joints is well known, but its effect on the hip joint and upper body movement during the gait of stroke patients remains unclear. Objectives: To compare the effect of an ankle–foot orthosis with plantar flexion stop and an ankle–foot orthosis with plantar flexion resistance on the gait of stroke patients in the subacute phase. Study design: Randomized controlled trial. Methods: A total of 42 stroke patients (mean age = 59.9 ± 10.9 years, 36 men and 4 women) in the subacute phase were randomized to each ankle–foot orthosis group in a parallel controlled trial with no blinding. Patients received gait training from physiotherapists using the specified ankle–foot orthosis for 2 weeks. Shod gait without an ankle–foot orthosis before training and gait with an ankle–foot orthosis after training were measured by three-dimensional motion analysis. Results: A total of 20 patients were analyzed in each group. Significant differences were found in pelvic and thoracic tilt angles between the two groups. Compared with the gait without an ankle–foot orthosis, the pelvis showed forward tilt when patients walked with an ankle–foot orthosis with plantar flexion stop, and the thorax showed decreased forward tilt when the patients walked with an ankle–foot orthosis with plantar flexion resistance. Conclusion: The difference in ankle–foot orthosis function in sagittal plantar flexion resistance affected the alignment of the upper body and the pelvis during the gait of stroke patients in the subacute phase. Clinical relevance Maintaining upright posture is important in gait rehabilitation. The findings of this study suggest that the ankle–foot orthosis with plantar flexion resistance facilitated better alignment of the upper body and pelvis during the gait of stroke patients in subacute phase. This type of ankle–foot orthosis could be beneficial for patients with malalignment of the upper body and pelvis.

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Microprocessor Controlled Knee Ankle Foot Orthosis (KAFO) vs Stance Control vs Locked KAFO: A Randomized Controlled Trial

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2020.08.013 ◽

2020 ◽

Author(s):

Susan Deems-Dluhy ◽

Shenan Hoppe-Ludwig ◽

Chaithanya K. Mummidisetty ◽

Patrick Semik ◽

Allen W. Heinemann ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Ankle Foot Orthosis ◽

Randomized Controlled ◽

Stance Control ◽

Foot Orthosis

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A comparison of orthoses in the treatment of idiopathic toe walking: A randomized controlled trial

Prosthetics and Orthotics International ◽

10.1177/0309364614564023 ◽

2015 ◽

Vol 40 (2) ◽

pp. 262-269 ◽

Cited By ~ 14

Author(s):

Kinsey Herrin ◽

Mark Geil

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Time Frame ◽

Functional Mobility ◽

Ankle Foot Orthosis ◽

Randomized Controlled ◽

Idiopathic Toe Walking ◽

Foot Orthosis ◽

Toe Walking ◽

Orthotic Treatment

Background:Orthotic treatment of idiopathic toe walking is complicated by the lack of a known etiology. This study compared control of toe walking using an articulated ankle–foot orthosis versus a rigid carbon fiber footplate attached to a foot orthosis.Objectives:Ascertain differences between two orthoses in the control of idiopathic toe walking.Study design:Randomized controlled trial.Methods:A total of 18 children with idiopathic toe walking were randomized to either the ankle–foot orthosis or foot orthosis treatment group in a Parallel Randomized Controlled Trial with no blinding. Prior to and after 6 weeks of treatment, participants completed three-dimensional gait assessment and the L-test of Functional Mobility. Parents completed a satisfaction survey and a subset of the Orthotic and Prosthetic User Survey after treatment.Results:Nine participants were analyzed in each group. Both groups showed significant improvement in kinematics versus baseline with orthoses; however, when the orthoses were removed, the ankle–foot orthosis group did not immediately sustain this improvement, while the foot orthosis group did. Parents preferred the foot orthosis for donning and appearance.Conclusion:The ankle–foot orthosis controls idiopathic toe walking, but subjects may revert to earlier patterns following treatment. The foot orthosis does not control idiopathic toe walking as well but is less restrictive and more accepted by children and their parents, with similar out-of-brace effects.Clinical relevanceThis study suggests that sequential orthotic treatment for children with idiopathic toe walking (ITW) may be beneficial. Initial treatment could include a less restrictive orthosis like a foot orthosis (FO); if this is unsuccessful within a set time frame, then the patient may require a more restrictive form of treatment such as an ankle–foot orthosis (AFO).

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