Ann Rehabil Med.  2013 Aug;37(4):516-522. 10.5535/arm.2013.37.4.516.

Effects on Foot External Rotation of the Modified Ankle-Foot Orthosis on Post-Stroke Hemiparetic Gait

• Kim HJ
• Chun MH
• Kim HM
• Kim BR

• KMID: 2266607
• DOI: http://doi.org/10.5535/arm.2013.37.4.516

Abstract

OBJECTIVE
To evaluate the effects of heel-opened ankle foot orthosis (HOAFO) on hemiparetic gait after stroke, especially on external foot rotation, and to compare the effects of HOAFO with conventional plastic-AFO (pAFO) and barefoot during gait.
METHODS
This cross-over observational study involved 15 hemiparetic patients with external rotation of the affected foot. All subjects were able to walk independently, regardless of their usual use of a single cane, and had a less than fair-grade in ankle dorsiflexion power. Each patient was asked to walk in three conditions with randomized sequences: 1) barefoot, 2) with a pAFO, and 3) with an HOAFO. Their gait patterns were analyzed using a motion analysis system.
RESULTS
Fifteen patients consisted of nine males and six females. On gait analysis, hip and foot external rotation were significantly greater in pAFO (-3.35degrees and -23.68degrees) than in barefoot and HOAFO conditions (p<0.05). Wearing an HOAFO resulted in significant decreases in hip (0.78degrees, p=0.04) and foot (-17.99degrees, p<0.01) external rotation compared with pAFO; although there was no significant difference between HOAFO and barefoot walking. Walking speed and percentage of single limb support were significantly greater for HOAFO than in barefoot walking.
CONCLUSION
HOAFO was superior to pAFO in reducing hip and foot external rotation during the stance phase in patients with post-stroke hemiparesis. HOAFO may, therefore, be useful in patients with excessive external rotation of the foot during conventional pAFO.

Keyword

Ankle-foot orthosis; Foot rotation; Gait; Stroke

MeSH Terms

Animals
Ankle
Canes
Extremities
Female
Foot
Foot Orthoses
Foot Rot
Gait
Hip
Humans
Male
Orthotic Devices
Paresis
Stroke
Walking

Figure

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  Fig. 1 Left heel-opened ankle foot orthosis. Heel of plastic ankle-foot orthosis was cut to reduce external rotation of foot during stance phase.

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