Article

This study was conducted to compare the effects of three ankle-foot orthosis
(AFO) designs on walking after stroke and determine whether an ankle plantar
flexion contracture impacts response to the AFOs. A total of 30 individuals,
ranging from 6-215 months post-stroke, were tested in four conditions: shoes only
(SH), dorsi-assist/dorsi-stop AFO (DA-DS), plantar stop/free dorsiflexion AFO
(PS), and rigid AFO (Rigid). Kinematics, kinetics, and electromyographic (EMG)
activity were recorded from the hemiparetic lower extremity while participants
walked at a self-selected pace. Gait parameters were compared between conditions
and between participants with and without a moderate ankle plantar flexion
contracture. All AFOs increased ankle dorsiflexion in swing and early stance.
Anterior tibialis EMG was reduced only in the PS AFO. Both PS and Rigid AFOs
restricted ankle plantar flexion and increased knee flexion in loading. Peak
ankle dorsiflexion in stance and soleus EMG intensity were greatest in the PS
AFO. The Rigid AFO tended to restrict dorsiflexion in stance and knee flexion in
swing only in participants without a plantar flexion contracture. Individuals
without a contracture benefit from an AFO that permits dorsiflexion mobility in
stance and those with quadriceps weakness may more easily tolerate an AFO with
plantar flexion mobility in loading.

Langue : ANGLAIS