The impact of dorsiflexion control on gait parameters in patients with stroke with hemiplegia using ankle foot orthoses.

BACKGROUND

Patients with stroke with hemiplegia often experience gait impairments and use ankle foot orthoses (AFOs) to support their walking. Despite the wide use of AFOs, the specific impact of dorsiflexion control in AFOs on gait parameters has yet to be clarified.

OBJECTIVES

This study aimed to evaluate the effects of 2 types of AFOs with different dorsiflexion control mechanisms on gait parameters in patients with stroke with hemiplegia.

STUDY

DESIGN

A cross-sectional comparative study.

METHODS

Eleven patients with stroke with hemiplegia were analyzed using 2 types of AFOs: a dorsiflexion-assisted AFO (Gait Solution Design®: GSD) and a bidirectional control AFO (WalkOn Trimable®: WOT). Gait analysis was performed using 3-dimensional motion analysis to measure gait speed, ankle plantarflexion moment, hip extension angle, shank inclination angle, and the percentage of terminal stance. Statistical analyses were conducted to compare the effects of GSD and WOT on these gait parameters.

RESULTS

The GSD significantly increased ankle plantarflexion moment and shank inclination angle, supporting the heel rocker (HR) and ankle rocker (AR) functions. In contrast, the WOT significantly increased hip extension angle and the percentage of terminal stance, facilitating the Forefoot Rocker function.

CONCLUSIONS

For patients with stroke with impaired HR and AR function, dorsiflexion-assisted AFOs like GSD are preferable. For patients with established HR and AR function but impaired Forefoot Rocker, bidirectional control AFOs such as WOT are recommended.