Efficacy of different techniques of AFO construction for hemiplegia patients: A systematic review

Abstract

Ankle foot orthosis (AFO) is frequently used to improve gait deviations in patients with hemiplegia. AFOs prevent foot drop in the swing phase and promote heel strike in the early stance phase of gait. →What this article adds: A variety of studies have reported the AFO is an effective tool for improving the gait pattern of hemiplegia patients. This study provided some guidelines to robustly report AFO interventions, mechanical characteristic of AFOs, and efficacy of AFOs' construction techniques, testing strategies and the outcomes.

Effect of Novel Spring Damper and Posterior Leaf Spring Ankle Foot Orthosis on the Vertical Component of Ground Reaction Forces During Walking in Patients With Drop Foot

“…In this study, while using spring damper AFO, the twopeak pattern of vGRF was near the normal condition. However, some studies have indicated that PLS or some conventional articulation AFOs with plantarflexion resistance were unable in restoring the normal pattern of vGRF [4]. In these AFOs, the peaks of vGRF at the early and terminal stance were decreased, and an extra peak was observed during the midstance.…”

“…The vGRF pattern could be explained by considering the magnitude of the acceleration and applied force, arising from the weight of the body in the opposite direction of the ground force (Newton's second law) [19]. Based on this concept, different types of lower or assistive devices may produce different vGRF patterns [4].…”

“…In drop foot disorder, ankle dorsiflexor muscles are weakened or paralyzed, leading to foot slap during the early step and the loss of ability to optimal toe clearance during the swing phase on the affected side [1][2][3]. As a result, some difficulties, like a decrease in walking speed, step length, and leg forward propulsion as well as changes in the Ground Reaction Force (GRF) pattern can be observed [2,[4][5][6].…”

“…To our knowledge, limited information is available to support the hypothesis about the relationship between VGRF and different hybrid passive AFOs. In this regard, Amerinatanzi found that some hybrid passive articulate AFOs can improve vGRF pattern and peaks to near normal condition [4]. In another study, Rogozinski reported that AFOs with articulation may improve the vGRF vector by altering gait kinematic parameters at the initial contact [10].…”

“…In another study, Rogozinski reported that AFOs with articulation may improve the vGRF vector by altering gait kinematic parameters at the initial contact [10]. However, some kinds of passive or stainless steel articulated hybrid passive AFOs deteriorated the pattern of vGRF with an extra peak at the mid-stance phase [4].…”