Long-term effect of an anterior ankle-foot orthosis on functional walking ability of chronic stroke patients.

Objectives: The objectives of this study are to investigate the long-term effect of anterior ankle-foot orthosis on the functional walking ability of chronic stroke patients and their subjective perception and to identify the type of chronic stroke patients who are better responders to the wearing of anterior ankle-foot orthosis.

Design: This is a cross-sectional cohort comparison study. Fifty-two stroke patients wearing an anterior ankle-foot orthosis for at least 5 mos were evaluated using the modified Emory Functional Ambulation Profile and the 6-min walking test with and without an anterior ankle-foot orthosis. Falls Efficacy Scale-International and a self-designed questionnaire were administered to assess subjective perceptions.

Results: All modified Emory Functional Ambulation Profile subscores significantly decreased with the anterior ankle-foot orthosis; the mean difference in favor of the anterior ankle-foot orthosis on the floor was -2.88 secs; the carpet, -5.44 secs; "up and go," -5.09 secs; obstacle, -8.42 secs; stairs, -6.45 secs; and in the 6-min walking test, 19.75 m (all P < 0.01). Patients who were of younger age or with low walking ability or both would have more benefits. The total scores of Falls Efficacy Scale-International were significantly lower with anterior ankle-foot orthosis as compared with that without anterior ankle-foot orthosis (31.57 ± 12.79 vs. 39.51 ± 12.65). Around 90% participants perceived that their walking performance improved with the anterior ankle-foot orthosis either indoors or outdoors, and they would recommend the anterior ankle-foot orthosis to other stroke patients. The greatest disadvantage of anterior ankle-foot orthosis is the difficulty in donning and doffing.

Conclusions: The effects of the anterior ankle-foot orthosis on stroke patients' functional walking ability and fall efficacy were significant. Patients who were of younger age or with low walking ability or both were more suitable for using the anterior ankle-foot orthosis.