Article

The aim of this study was to assess the functional effects and mechanical
contribution of Ankle Foot Orthoses (AFO) prescribed to overcome drop-foot gait.
We hypothesized that poor functional effects of the AFO relate to insufficient
mechanical contribution of the AFO during the swing phase, or unwanted
constraining of the ankle during the stance phase. In seven patients with Stroke
or Multiple Sclerosis, we determined changes in energy cost of walking resulting
from wearing an AFO, as a measure of the functional effects. In addition, an
instrumented gait analysis was performed, and the mechanical AFO properties were
measured, to calculate the mechanical contribution of the AFO. The AFO was
sufficiently stiff to effectively support the foot in swing, without hampering
the ankle during stance. For the whole group, there was a significant improvement
in walking speed and energy cost (12%). However, the AFO had no functional
benefit in terms of a reduced energy cost of walking for three patients, who
coherently demonstrated no pathological plantar flexion during swing without
their AFO. We conclude that functional benefit from the AFO was only found when
the mechanical AFO characteristics met the need to support the patients'
mechanical deficiencies.

Langue : ANGLAIS