Effects of two different types of ankle foot orthoses on gait outcomes in patients with subacute stroke
Ankle Foot Orthosis (AFO) is a commonly prescribed device to improve foot drop and gait in patients with stroke. The purpose of this study was to identify whether patients in the subacute stage of stroke, with foot drop, would have better gait outcomes when using a double adjustable AFO (DA AFO), or a posterior leaf spring AFO (PLS AFO). A secondary purpose was to determine whether one week of practice would significantly change gait outcomes with either of the AFO conditions when compared to baseline. 20 participants in the subacute stage of stroke recovery completed this repeated measure study. Outcomes measured were gait endurance, gait symmetry, gait velocity and self-reported preference of AFO. Paired t-test, used to test for significance of differences revealed no significant differences between the two AFOs at baseline (p > .05). A repeated measures analysis of variance, used to test significant differences in gait endurance was not significant for the interaction between the AFO conditions after a week of practice (p = .077). Main effect of practice and main effect of type of AFO revealed statistical significance (p <.001, p = .046) A repeated measures multivariate analysis of variance (MANOVA) used to test for the gait symmetry between the AFO conditions after a week of practice, revealed no significant interaction at self-selected velocity (p =. 397) and fast-paced velocity (p = .113). A repeated measures MANOVA, used to test for the gait velocity between the AFO conditions after a week of practice revealed no significant interaction at self-selected velocity (p =. 209) and fast-paced velocity (p = .280). The main effect of practice was significant at self-selected velocity (p =.001) and at fast paced velocity (p <.001). Sixteen participants preferred using DA AFO and four participants preferred using PLS AFO for their walking. In conclusion, participants in subacute stage of stroke recovery did not differ significantly between DA AFO and PLS AFO with gait endurance, gait symmetry and gait velocity at baseline. With practice, participants significantly improved with gait endurance and gait velocity regardless of the type of AFO used.