Relative contribution of footwear to the efficacy of ankle-foot orthoses.

OBJECTIVE

To examine the relative effects of footwear and an ankle-foot orthosis (AFO) on hemiplegic gait.

DESIGN

A case series with three contrasting conditions: walking without footwear, with footwear alone, and with footwear and an AFO. Spatio-temporal parameters reflecting walking performance were analysed using an analysis of variance (ANOVA).

PATIENTS: Five patients with hemiplegia and reduced mobility following stroke.

SETTING

A specialist rehabilitation centre.

INTERVENTION: Wearing either footwear alone, or footwear with an AFO.

MEASURES: Video recordings of gait were subjected to a kinematic analysis to determine spatio-temporal parameters.

RESULTS

Stride length was increased by an average of 5 cm when wearing footwear. An additional 5-cm increase was also observed when wearing an AFO. Swing velocity was also affected by the manipulation.

CONCLUSIONS

The appropriate comparative baseline for assessing the efficacy of an AFO is subjects walking with existing footwear and not barefoot.