Abstract
OBJECTIVE: To study role of ankle foot orthosis (AFO) in improving locomotion and functional recovery after stroke. SETTING: Neurological Rehabilitation Department of a university research tertiary hospital. PATIENTS AND METHODS: AFO and activity based rehabilitation. MAIN OUTCOME MEASURES: Distance (meters) covered during the 6-minute walk test (6MWT) and speed (meter/second) during the 10-meter walk test. Functional abilities assessed using Functional Independence Measure (FIM(®)). RESULTS: Twenty-six patients (21 male) with stroke (mean duration 196.7 days, range 45-360 days) and mean age of 41.6 years (range 18-65 years, standard deviation [SD] 12.5) were included. Fourteen had right hemiplegia. The mean length of stay in the unit was 26.5 days (range 18-45 days, SD 5.5). All patients had equinus deformity with spastic foot drop and were provided with AFO. Walking endurance with 6MWT was 90 m on admission (without AFO). At discharge, it improved to 174 m with AFO and 121 m without AFOs (P < 0.001-with and without AFO at discharge). Walking speed improved from 0.4 m/s (admission) to 0.51 m/s with AFO, P = 0.004 and 0.45 m/s without AFO, P = 0.015) at discharge. Nine patients (34.6%) had clinically important difference-minimal clinically important difference (>0.16 m/s speed gain; >50 m endurance gain) at discharge. The mean FIM(®) score on admission was 84.3 ± 18.6. At discharge FIM(®) improved to 101.9 ± 13.7 (P < 0.001). CONCLUSIONS: Use of AFOs improve gait parameters significantly in only one-third stroke patients in the study when combined with activity-based inpatient-rehabilitation.