ORLANDO, Fla.  —  A literature review on the use of ankle foot orthoses in post-stroke patients found conflicting evidence of efficacy based on several different outcome measures. Jason Jennings, BS, CPO, LPO, FAAOP, area clinic manager at Hanger clinic, Houston, presented results of the review at the O&P World Congress, here.

“The impetus for this review was to inform a working group that is developing clinical practice guidelines for the use of orthotic interventions post-stroke,” Jennings said.

Strong evidence was found in 31 studies that supported the use of ankle foot orthoses (AFOs) to improve gait in post-stroke patients, Jennings and colleagues found.


Jason Jennings

Researchers found conflicting evidence on AFO use to improve balance in post-stroke patients in 11 studies that measured balance with and without AFOs . In 10 studies that assessed some measure of energy expenditure with and without AFOs, moderate evidence supported their use to decrease energy cost of walking post-stroke.

In six studies that assessed muscle activity related to tone or spasticity, the researchers found limited evidence that AFOs decreased tibialis anterior muscle activation during swing and decreased plantar flexion during swing. Additionally, AFOs had no effect on measures of spasticity.

 “There is a plethora of outcome measures. We made no attempt to decide which were the most important outcomes for assessing these interventions,” Jennings said. “We are not there yet. Effectiveness of interventions in some areas has been demonstrated and hopefully this will help to identify areas where future studies are needed. “

For more information:

Jennings J. Symposium: Advances in lower limb orthotic management for post-stroke hemiparesis – an interdisciplinary approach. Presented at: O&P World Congress. Sept. 18-21, 2013. Orlando, Fla.

Disclosure: Jennings has no relevant financial disclosures.

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