Affiliations: [a] Kessler Foundation Research Center, West Orange, NJ, USA | [b] Department of Physical Medicine and Rehabilitation, UMDNJ – New Jersey Medical School, Newark, NJ, USA | [c] University of Nebraska, Omaha, NE, USA | [d] Division of Physical Medicine and Rehabilitation, School of Medicine, University of Utah, Salt Lake City, UT, USA
Correspondence:
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Address for correspondence: Karen J. Nolan, PhD, Kessler Foundation Research Center, 1199 Pleasant Valley Way, West Orange, NJ, USA. Tel.: +1 973 324 3544; Fax: +1 973 324 3536; E-mail: knolan@kesslerfoundation.org
Abstract: This investigation utilized a single case design to evaluate the effects of a dynamic AFO on ambulation in post stroke hemiplegia. A single patient with stroke related hemiplegia using a dynamic AFO underwent gait analysis while walking on level ground. Outcome measures included temporal-spatial gait parameters and bilateral kinematic joint angles at the ankle, knee, and hip with and without AFO. Walking speed, stride length, step length and cadence increased with the dynamic AFO. Step width and double support decreased, while single support remained unchanged on the affected limb with the dynamic AFO. With the dynamic AFO there was increased hip flexion at foot strike and toe-off, increased hip sagittal plane angular velocity during swing, and decreased abduction. The dynamic AFO had a positive effect on the participant's overall gait which included improved temporal-spatial parameters and gait velocity which is likely due to a decrease in the overall energy cost of walking. Kinematic angles at the hip were most notably affected by brace utilization and this effect should be more fully explored. Further research with a larger sample utilizing dynamic AFOs is indicated to explore the generalizability of these findings and to determine the potential utility of these braces as an alternative to the traditionally prescribed solid AFO.
