Brain Neurorehabil.  2013 Mar;6(1):1-8. 10.12786/bn.2013.6.1.1.

Effects of Ankle Foot Orthosis on Post-stroke Hemiplegic Gait -A Meta-analysis-

• Kim DY
• Kim SK
• Park JB
• Yang JK

• KMID: 2270733
• DOI: http://doi.org/10.12786/bn.2013.6.1.1

Abstract

OBJECTIVE
The aim of this meta-analysis was to investigate the effects of ankle foot orthosis on adult post-stroke hemiplegic patients' walking ability and pattern. METHOD: We searched for the case controlled clinical trials about the effects of ankle foot orthosis (AFO) for walking ability and pattern using quantitative gait analysis in adult post-stroke patients, which published between January 1950 and July 2012 in PubMed, and searching engine of Journal of Korean Academy of Rehabilitation Medicine. The mean standardized difference (MSD) and a 95% confidence interval (CI) were estimated for gait ability and pattern using fixed effect models.
RESULTS
Sixteen of the 56 articles were included in this analysis. The selected studies involved a total of 274 patients. The walking speed, cadence, the portion of double limb supporting, stride length on affected side, the portion of swing period on unaffected side, and symmetry of swing period were improved by AFO. The oxygen cost was decreased by AFO. The AFO did improve ankle dorsiflexion at initial contact, maximal ankle dorsiflexion at swing phase, but the ankle plantar flexion at push-off did not.
CONCLUSION
The ankle foot orthosis has some evidence to improve the walking ability and gait pattern in post-stroke hemiplegic patients.

Keyword

gait; hemiplegia; meta-analysis; orthotic devices; stroke

MeSH Terms

Adult
Animals
Ankle
Case-Control Studies
Extremities
Foot
Foot Orthoses
Gait
Gait Disorders, Neurologic
Hemiplegia
Humans
Orthotic Devices
Oxygen
Stroke
Walking
Oxygen

Figure

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  Fig. 1 Comparison of walking speed (m/sec) between with and without AFO.

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  Fig. 2 Comparison of cadence (step/min) between with and without AFO.

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  Fig. 3 Comparison of stride length (cm) on affected side between with and without AFO.

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  Fig. 4 Comparison of step length (cm) between with and without AFO (A: affected side, B: unaffected side).

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  Fig. 5 Comparison of double supporting time (%) between with and without AFO.

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  Fig. 6 Comparison of portion of phase (%) on affected side between with and without AFO (A: portion of stance phase, B: portion of swing phase).

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  Fig. 7 Comparison of portion of phase (%) on unaffected side between with and without AFO (A: portion of stance phase, B: portion of swing phase).

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  Fig. 8 Comparison of symmetry at swing phase (%) between with and without AFO (A: stance phase, B: swing phase).

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  Fig. 9 Comparison of energy consumption between with and without AFO (A: oxygen rate (ml/kg/min), B: oxygen cost (ml/kg/m)).

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  Fig. 10 Comparison of ankle kinematic parameters between with and without AFO (A: ankle dorsiflexion at initial contact (°), B: maximal ankle dorsiflexion at stance phase (°), C: ankle plantar flexion at push-off phase (°), D: maximal ankle dorsiflexion at swing phase (°)).

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