Foot Drop Stimulation Versus Ankle Foot Orthosis After Stroke: 30-Week Outcomes Early or delayed provision of an ankle-foot orthosis in patients with acute and subacute stroke: a randomized controlled trial Effect of early compensation of distal motor deficiency by the Chignon ankle-foot orthosis on gait in hemiplegic patients: a randomized pilot study AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both Does Functional Electrical Stimulation for Foot Drop Strengthen Corticospinal Connections? Walking Training with Foot Drop Stimulator Controlled by a Tilt Sensor to Improve Walking Outcomes: A Randomized Controlled Pilot Study in Patients with Stroke in Subacute Phase The effects of dynamic ankle-foot orthoses in chronic stroke patients at three-month follow-up: a randomized controlled trial Effects of an implantable two-channel peroneal nerve stimulator versus conventional walking device on spatiotemporal parameters and kinematics of hemiparetic gait. The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. Effect of a Foot-Drop Stimulator and Ankle–Foot Orthosis on Walking Performance After Stroke The effect of different shoes on functional mobility and energy expenditure in post-stroke hemiplegic patients using ankle–foot orthosis The influence of early or delayed provision of ankle-foot orthoses on pelvis, hip and knee kinematics in patients with sub-acute stroke: A randomized controlled trial. A feasibility study to investigate the clinical application of functional electrical stimulation (FES), for dropped foot, during the sub-acute phase of stroke – A randomized controlled trial Surface Peroneal Nerve Stimulation in Lower Limb Hemiparesis: Effect on Quantitative Gait Parameters A randomized controlled trial of an implantable 2-channel peroneal nerve stimulator on walking speed and activity in poststroke hemiplegia. Comparison of ankle–foot orthoses with plantar flexion stop and plantar flexion resistance in the gait of stroke patients: A randomized controlled trial
Background and Purpose — Drop foot after stroke may be addressed using an ankle foot orthosis ( AFO ) or a foot drop stimulator ( FDS ) . The Functional Ambulation : St and ard Treatment versus Electric Stimulation Therapy ( FASTEST ) trial was a multicenter , r and omized , single-blinded trial comparing FDS and AFO for drop foot among people ≥3 months after stroke with gait speed ⩽0.8 m/s . Methods — Participants ( n=197 ; 79 females and 118 males ; 61.14±11.61 years of age ; time after stroke 4.55±4.72 years ) were r and omized to 30 weeks of  either FDS or a st and ard AFO . Eight dose-matched physical therapy sessions were provided to both groups during the first 6 weeks of the trial . Results — There was significant improvement within both groups from baseline to 30 weeks in comfortable gait speed ( 95 % confidence interval for mean change , 0.11–0.17 m/s for FDS and 0.12–0.18 m/s for AFO ) and fast gait speed . However , no significant differences in gait speed were found in the between-group comparisons . Secondary outcomes ( st and ard measures of body structure and function , activity , and participation ) improved significantly in both groups , whereas user satisfaction was significantly higher in the FDS group than in the control group . Conclusions — Using either an FDS or an AFO for 30 weeks yielded clinical ly and statistically significant improvements in gait speed and other functional outcomes . User satisfaction was higher in the FDS group . Although both groups did receive intervention , this large clinical trial provides evidence that FDS or AFO with initial physical therapy sessions can provide a significant and clinical ly meaningful benefit even years after stroke . Clinical Trial Registration Information— URL : http://www . clinical trials.gov . Unique Identifier : NCT01138995 Objective : ( 1 ) To study the effects of providing ankle-foot orthoses in subjects with (sub)acute stroke ; and ( 2 ) to study whether the point in time at which an ankle-foot orthosis is provided post-stroke ( early or delayed ) influences these effects . Design : R and omized controlled trial . Setting : Rehabilitation centre . Subjects : Unilateral hemiparetic stroke subjects with indication for use of an ankle-foot orthosis and maximal six weeks post-stroke . Interventions : Subjects were r and omly assigned to : early provision ( at inclusion ; Week 1 ) or delayed provision ( eight weeks later ; Week 9 ) . Outcome measures : 10-metre walk test , 6-minute walk test , Timed Up and Go Test , stairs test , Functional Ambulation Categories , Berg Balance Scale , Rivermead Mobility Index and Barthel Index ; assessed in Weeks 1 , 3 , 9 and 11 . Results : A total of 33 subjects were r and omized ( 16 early , 17 delayed ) . Positive effects of ankle-foot orthoses were found two weeks after provision , both when provided early ( significant effects on all outcomes ) or delayed ( Berg Balance Scale p = 0.011 , Functional Ambulation Categories p = 0.008 , 6-minute walk test p = 0.005 , Timed Up and Go Test p = 0.028 ) . Comparing effects after early and delayed provision showed that early provision result ed in increased levels of improvement on Berg Balance Scale ( + 5.1 points , p = 0.002 ) , Barthel Index ( + 1.9 points , p = 0.002 ) and non-significant improvements on 10-metre walk test ( + 0.14 m/s , p = 0.093 ) and Timed Up and Go Test ( –5.4 seconds , p = 0.087 ) , compared with delayed provision . Conclusions : We found positive effects of providing ankle-foot orthoses in (sub)acute stroke subjects that had not used these orthoses before Objective : To compare the effect of the Chignon ankle-foot orthosis on gait versus a st and ard ankle-foot orthosis . Method : A multicentre r and omized study was conducted in seven rehabilitation centres . Hemiplegic patients were recruited after unilateral stroke lasting less than six months . Exclusion criteria were : impossibility to st and for 10 seconds ; ankle passive dorsiflexion < 5 degrees with knee flexed to 90 degrees ; triceps spasticity ≥3/4 on the Ashworth modified scale ; diseases that might impair active participation in the study . Thirteen patients were r and omized to the Chignon group and 15 to the control group . Included patients were given a st and ard ankle-foot orthosis or Chignon ankle-foot orthosis . The Chignon ankle-foot orthosis is an articulated double-stopped custom-made orthosis with elements to assist dorsiflexion and plantar flexion . Gait speed improvement ( ten-metre test ) , kinematic assessment , and functional scales were assessed . Results : Gain ratio of walking speed with the  orthosis increased significantly more in the Chignon group than in the control group at day 0 ( 27.2 ± 36 % versus −0.8 ± 17 % ; P = 0.006 ) , day 30 ( 39.9 ± 19 % versus 7.5 ± 17 % ; P = 0.0004 ) and day 90 ( 44.6 ± 27 % versus 17.1 ± 0.3 % ; P = 0.04 ) . There was also a significant improvement in kinematic parameters and spasticity in the Chignon group . Conclusion : Early compensation of distal motor deficiency by the Chignon ankle-foot orthosis improves the immediate gait of hemiplegics more than the st and ard ankle-foot orthosis and seems to modify motor recovery processes in the legs after stroke The number of published systematic review s of studies of healthcare interventions has increased rapidly and these are used extensively for clinical and policy decisions . Systematic review s are subject to a range of biases and increasingly include non-r and omised studies of interventions . It is important that users can distinguish high quality review s. Many instruments have been design ed to evaluate different aspects of review s , but there are few comprehensive critical appraisal instruments . AMSTAR was developed to evaluate systematic review s of r and omised trials . In this paper , we report on the updating of AMSTAR and its adaptation to enable more detailed assessment of systematic review s that include r and omised or non-r and omised studies of healthcare interventions , or both . With moves to base more decisions on real world observational evidence we believe that AMSTAR 2 will assist decision makers in the identification of high quality systematic review s , including those based on non-r and omised studies of healthcare interventions Background . Long-term use of a foot-drop stimulator applying functional electrical stimulation ( FES ) to the common peroneal nerve improves walking performance even when the stimulator is off . This “ therapeutic ” effect might result from neuroplastic changes . Objective . To determine the effect of long-term use of a foot-drop stimulator on residual corticospinal connections in people with central nervous system disorders . Methods . Ten people with nonprogressive disorders ( eg , stroke ) and 26 with progressive disorders ( eg , multiple sclerosis ) used a foot-drop stimulator for 3 to 12 months while walking in the community . Walking performance and electrophysiological variables were measured before and after FES use . From the surface electromyogram of the tibialis anterior muscle , we measured the following : ( 1 ) motor-evoked potential ( MEP ) from transcranial magnetic stimulation over the motor cortex , ( 2 ) maximum voluntary contraction ( MVC ) , and ( 3 ) maximum motor wave ( Mmax ) from stimulating the common peroneal nerve . Results . After using FES , MEP and MVC increased significantly by comparable amounts , 50 % and 48 % , respectively , in the nonprogressive group and 27 % and 17 % in the progressive group ; the changes were positively correlated ( R 2 = .35 ; P < .001 ) . Walking speed increased with the stimulator off ( therapeutic effect ) by 24 % ( P = .008 ) and 7 % ( P = .014 ) in the nonprogressive and progressive groups , respectively . The changes in Mmax were small and not correlated with changes in MEP . Conclusions . The large increases in MVC and MEP suggest that regular use of a foot-drop stimulator strengthens activation of motor cortical areas and their residual descending connections , which may explain the therapeutic effect on walking speed Foot drop is a quite common problem in nervous system disorders . Neuromuscular electrical stimulation ( NMES ) has showed to be an alternative approach to correct foot drop improving walking ability in patients with stroke . In this study , twenty patients with stroke in subacute phase were enrolled and r and omly divided in two groups : one group performing the NMES ( i.e. Walkaide Group , WG ) and the Control Group ( CG ) performing conventional neuromotor rehabilitation . Both groups underwent the same amount of treatment time . Significant improvements of walking speed were recorded for WG ( 168 ± 39 % ) than for CG ( 129 ± 29 % , P = 0.032 ) as well as in terms of locomotion ( Functional Ambulation Classification score : P = 0.023 ) . In terms of mobility and force , ameliorations were recorded , even if not significant ( Rivermead Mobility Index : P = 0.057 ; Manual Muscle Test : P = 0.059 ) . Similar changes between groups were observed for independence in activities of daily living , neurological assessment s , and spasticity reduction . These results highlight the potential efficacy for patients affected by a droop foot of a walking training performed with a neurostimulator in subacute phase Objective : To investigate the short- and long-term effects of dynamic ankle foot orthoses on functional ambulation activities in chronic hemiparetic patients . Design : R and omized controlled trial . Setting : University ’s neurological rehabilitation outpatient clinic and orthotics department . Subjects : Twenty-eight chronic hemiparetic patients of level 3–5 according to Functional Ambulation Classification and with a maximum spasticity level of 3 according to Modified Ashworth Scale , were r and omly assigned to the study and control groups . Interventions : The control group ( n = 14 ) was assessed with tennis shoes whereas the study group ( n = 14 ) was assessed initially with tennis shoes and after three months with dynamic ankle foot orthosis . Measures : Functional Reach , Timed Up and Go , Timed Up Stairs , Timed Down Stairs , gait velocity and Physiological Cost Index . Results : In the initial assessment no difference was found between the groups for any of the measured parameters ( P > 0.05 ) . After three months , intergroup comparisons while the patients in the study group were wearing dynamic ankle-foot orthosis showed a significant difference in favour of the study group for Timed Up Stairs 12.00 ( 10.21 ) seconds study versus 15.00 ( 7.29 ) seconds control group ; for gait velocity 0.99 ( 0.45 ) m/s study versus 0.72 ( 0.20 ) m/s control group and for Physiological Cost Index 0.12 ( 0.06 ) beats/min study versus 0.28 ( 0.13 ) beats/min control group ( P < 0.05 ) . No difference was found between the groups for Functional Reach , Timed Up and Go , Timed Down Stairs ( P > 0.05 ) . Conclusion : Chronic hemiparetic patients may benefit from using dynamic ankle-foot orthosis OBJECTIVE The aims of this study were : ( i ) to compare the neuro-prosthetic effect of implantable peroneal nerve stimulation to the orthotic effect of a st and ard of care intervention ( no device , shoe or ankle foot orthosis ) on walking , as assessed by spatiotemporal parameters ; and ( ii ) to examine whether there is evidence of an enhanced lower-limb flexion reflex with peroneal nerve stimulation and compare the kinematic effect of an implantable peroneal nerve stimulation device vs st and ard of care intervention on initial loading response of the paretic limb , as assessed by hip , knee and ankle kinematics . DESIGN R and omized controlled trial . SUBJECTS A total of 23 chronic stroke survivors with drop foot . METHODS The intervention group received an implantable 2-channel peroneal nerve stimulator for correction of drop foot . The control group continued using a conventional walking device .  Spatiotemporal parameters and hip , knee and ankle kinematics were measured while subjects walked with the device on using a 3-dimensional video camera system during baseline and after a follow-up period of 26 weeks . RESULTS Peroneal nerve stimulation normalized stance and double support of the paretic limb and single support of the non-paretic limb , in comparison with using a conventional walking device . In addition , peroneal nerve stimulation is more effective to provide ankle dorsiflexion during swing and result ed in a normalized initial loading response . CONCLUSION Although peroneal nerve stimulation and ankle foot orthosis are both prescribed to correct a drop foot in the same patient population , spatiotemporal parameters , dorsiflexion during swing and loading response are influenced in a functionally different way Most systematic review s rely substantially on the assessment of the method ological quality of the individual trials . The aim of this study was to obtain consensus among experts about a set of generic core items for quality assessment of r and omized clinical trials ( RCTs ) . The invited participants were experts in the field of quality assessment of RCTs . The initial item pool contained all items from existing criteria lists . Subsequently , we reduced the number of items by using the Delphi consensus technique . Each Delphi round comprised a question naire , an analysis , and a feedback report . The feedback report included staff team decisions made on the basis of the analysis and their justification . A total of 33 international experts agreed to participate , of whom 21 completed all question naires . The initial item pool of 206 items was reduced to 9 items in three Delphi rounds . The final criteria list ( the Delphi list ) was satisfactory to all participants . It is a starting point on the way to a minimum reference st and ard for RCTs on many different research topics . This list is not intended to replace , but rather to be used alongside , existing criteria lists Background . Studies have demonstrated the efficacy of functional electrical stimulation in the management of foot drop after stroke . Objective . To compare changes in walking performance with the WalkAide ( WA ) foot-drop stimulator and a conventional ankle – foot orthosis ( AFO ) . Methods . Individuals with stroke within the previous 12 months and residual foot drop were enrolled in a multicenter , r and omized controlled , crossover trial . Subjects were assigned to 1 of 3 parallel arms for 12 weeks ( 6 weeks/device ) : arm 1 ( WA – AFO ) , n = 38 ; arm 2 ( AFO – WA ) , n = 31 ; arm 3 ( AFO – AFO ) , n = 24 . Primary outcomes were walking speed and Physiological Cost Index for the Figure-of-8 walking test . Secondary measures included 10-m walking speed and perceived safety during this test , general mobility , and device preference for arms 1 and 2 for continued use . Walking tests were performed with ( On ) and without a device ( Off ) at 0 , 3 , 6 , 9 , and 12 weeks . Results . Both WA and AFO had significant orthotic ( On – Off difference ) , therapeutic ( change over time when Off ) , and combined ( change over time On vs baseline Off ) effects on walking speed . An AFO also had a significant orthotic effect on Physiological Cost Index . The WA had a higher , but not significantly different therapeutic effect on speed than an AFO , whereas an AFO had a greater orthotic effect than the WA ( significant at 12 weeks ) . Combined effects on speed after 6 weeks did not differ between devices . Users felt as safe with the WA as with an AFO , but significantly more users preferred the WA . Conclusions . Both devices produce equivalent functional gains Background : Ankle – foot orthoses could be utilized both with and without shoes . While several studies have shown that ankle – foot orthoses improve gait abilities in hemiplegic patients , it remains unclear whether they should be used with shoes or without . Objectives : The study purpose was to compare the effect of st and ard shoes and rocker shoes on functional mobility in post-stroke hemiplegic patients utilizing ankle – foot orthosis .  Study design : R and omized clinical study . Methods : Thirty post-stroke hemiplegic patients participated in this study r and omly assigned to two groups . Group I received st and ard shoes + ankle – foot orthosis and group II were provided with rocker shoes + ankle – foot orthosis . Their functional mobility and energy expenditure parameters including timed up and go , timed up stairs , timed down stairs , preferred walking speed , and oxygen ( O2 ) cost ( mL/kg/m ) were measured . Results : In group I , no significant changes were seen in outcome measures after wearing st and ard shoes . While in group II , O2 cost and timed up and go time significantly decreased , and preferred walking speed increased when patients wore rocker shoes . Also , there was a significant difference between rocker shoes and st and ard shoes in improvement of timed up and go , preferred walking speed , and O2 cost . Conclusion : When patients using ankle – foot orthosis wore rocker shoes , their functional mobility improved and oxygen cost diminished . Also , rocker shoes was significantly more effective than st and ard shoes in improving functional mobility parameters . Clinical relevance This study suggests that in post-stroke hemiplegic patients using ankle – foot orthosis , wearing rocker shoes can lead to much more improved functional mobility and decreased energy expenditure compared to ankle – foot orthosis only . Thus , in stroke patients , the combination of ankle – foot orthosis-rocker shoes is recommended for both rehabilitation programs and ankle – foot orthosis efficacy investigations BACKGROUND Compensatory pelvis , hip- and knee movements are reported after stroke to overcome insufficient foot-clearance . Ankle-foot orthoses ( AFOs ) are often used to improve foot-clearance , but the optimal timing of AFO-provision post-stroke is unknown . Early AFO-provision to prevent foot-drop might decrease the development of compensatory movements , but it is unknown whether timing of AFO-provision affects post-stroke kinematics . RESEARCH QUESTIONS 1 ) To compare the effect of AFO-provision at two different points in time ( early versus delayed ) on frontal pelvis and hip , and sagittal hip and knee kinematics in patients with sub-acute stroke . Effects were assessed after 26 weeks ; 2 ) To study whether possible changes in kinematics or walking speed during the 26-weeks follow-up period differed between both groups . METHOD An explorative r and omized controlled trial was performed , including unilateral hemiparetic patients maximal six weeks post-stroke with indication for AFO-use . Subjects were r and omly assigned to AFO-provision early ( at inclusion ) or delayed ( eight weeks later ) . 3D gait- analysis with and without AFO was performed in r and omized order . Measurements were performed in study -week 1 , 9 , 17 and 26 . RESULTS Twenty-six subjects ( 15 early , 11 delayed ) were analyzed . After 26 weeks , no differences in kinematics were found between both groups for any of the joint angles , both for the without and with AFO-condition . Changes in kinematics during the 26-weeks follow-up period did not differ between both groups for any of the joint angles during walking without AFO . Significant differences in changes in walking speed during the 26-weeks follow-up were found ( p = 0.034 ) , corresponding to the first eight weeks after AFO-provision . SIGNIFICANCE Results indicate that early or delayed AFO-use post-stroke does not influence pelvis , hip and knee movements after 26 weeks , despite that AFO-use properly corrected drop-foot . AFOs should be provided to improve drop-foot post-stroke , but not with the intention to influence development of compensatory patterns around pelvis and hip Purpose Functional electrical stimulation ( FES ) , for dropped foot , has been shown to have positive benefits in chronic stroke . It has been suggested that similar benefits may be seen earlier after stroke . The aim of this feasibility study was to evaluate the trial methodology of undertaking a r and omized controlled trial ( RCT ) of FES in sub-acute stroke . Method : This was a r and omized feasibility study with non-blinded outcomes at 6 and 12 weeks . Sixteen sub-acute stroke in- patients with dropped foot were r and omized into two groups ( control , n = 7 ; intervention , n = 9 ) . Both groups received routine gait re-education and an orthotic device , the control group used an ankle foot orthosis and the intervention group used FES . Outcome measures included gait velocity and cadence , Functional Ambulation Classification , Visual Analogue Scale of perception of walking , and the Stroke Impact Scale . Results : Eligibility criteria developed for inclusion of participants in the trial were appropriate . Set-up of FES during sub-acute stroke was feasible but more challenging than with chronic patients . Outcome measures were suitable and have informed the choice of measures for future work . Conclusions : It is feasible to undertake a trial evaluating FES during the sub-acute phase of recovery after stroke . A larger RCT is required Objective The objective of this study was to evaluate possible mechanisms for functional improvement and compare ambulation training with surface peroneal nerve stimulation vs. usual care via quantitative gait analysis . Design This study is a r and omized controlled clinical trial . Setting The setting of this study is a teaching hospital of an academic medical center . Participants One hundred ten chronic stroke survivors ( > 12 wks poststroke ) with unilateral hemiparesis participated in this study . Interventions The subjects were r and omized to a surface peroneal nerve stimulation device or usual care intervention . The subjects were treated for 12 wks and followed up for 6-mo posttreatment . Main Outcome Measures Spatiotemporal , kinematic , and kinetic parameters of gait were the main outcome measures . Results Cadence ( F3,153 = 5.81 , P = 0.012 ) , stride length ( F3,179 = 20.01 , P < 0.001 ) , walking speed ( F3,167 = 18.2 , P < 0.001 ) , anterior-posterior ground reaction force ( F3,164 = 6.61 , P = 0.004 ) , peak hip power in preswing ( F3,156 = 8.76 , P < 0.001 ) , and peak ankle power at push-off ( F3,149 = 6.38 , P = 0.005 ) all improved with respect to time . However , peak ankle ankle dorsiflexion in swing ( F3,184 = 4.99 , P = 0.031 ) worsened . In general , the greatest change for all parameters occurred during the treatment period . There were no significant treatment group × time interaction effects for any of the spatiotemporal , kinematic , or kinetic parameters . Conclusions Gait training with peroneal nerve stimulation and usual care was associated with improvements in peak hip power in preswing and peak ankle power at push-off , which may have result ed in improved cadence , stride length , and walking speed ; however , there were no differences between treatment groups . Both treatment groups also experienced a decrease in peak ankle ankle dorsiflexion in swing , although the clinical implication s of this finding are unclear OBJECTIVE To determine the effect of a new implantable 2-channel peroneal nerve stimulator on walking speed and daily activities , in comparison with the usual treatment in chronic stroke survivors with a drop foot . DESIGN R and omized controlled trial . SETTING All subjects were measured 5 times in the gait laboratory . PARTICIPANTS Twenty-nine stroke survivors with chronic hemiplegia with drop foot who fulfill the predefined inclusion and exclusion criteria were included in the study . INTERVENTION The intervention group received an implantable 2-channel peroneal nerve stimulator for correction of their drop foot . The control group continued using their conventional walking device , consisting of an ankle-foot orthosis , orthopedic shoes , or no device . MAIN OUTCOME MEASURES Walking speed , assessed both by a six-minute walk test ( 6MWT ) and by using a 10-m walkway , was selected as primary outcome measure and activity monitoring data , consisting of percentage time spent on stepping , st and ing , and sitting/lying were selected as secondary outcome measure . RESULTS Functional electric stimulation ( FES ) result ed in a 23 % improvement of walking speed measured with the 6MWT , whereas the improvement in the control group was only 3 % ( P=.010 ) . Comfortable walking speed measured on a 10-m walkway was also significantly improved in favor of FES ( P=.038 ) . The percentage time spent on stepping deteriorated with 3 % in the intervention and 0.8 % in control group , which was not statistically significant between both groups ( P=.13 ) . CONCLUSIONS The present study shows a clinical ly relevant effect of the implantable 2-channel peroneal nerve stimulator on walking speed in the sample of stroke survivors included in our study Background : The effect of plantar flexion resistance of ankle – foot orthoses on the ankle and knee joints is well known , but its effect on the hip joint and upper body movement during the gait of stroke patients remains unclear . Objectives : To compare the effect of an ankle – foot orthosis with plantar flexion stop and an ankle – foot orthosis with plantar flexion resistance on the gait of stroke patients in the subacute phase . Study design : R and omized controlled trial . Methods : A total of 42 stroke patients ( mean age = 59.9 ± 10.9 years , 36 men and 4 women ) in the subacute phase were r and omized to each ankle – foot orthosis group in a parallel controlled trial with no blinding . Patients received gait training from physiotherapists using the specified ankle – foot orthosis for 2 weeks . Shod gait without an ankle – foot orthosis before training and gait with an ankle – foot orthosis after training were measured by three-dimensional motion analysis . Results : A total of 20 patients were analyzed in each group . Significant differences were found in pelvic and thoracic tilt angles between the two groups . Compared with the gait without an ankle – foot orthosis , the pelvis showed forward tilt when patients walked with an ankle – foot orthosis with plantar flexion stop , and the thorax showed decreased forward tilt when the patients walked with an ankle – foot orthosis with plantar flexion resistance . Conclusion : The difference in ankle – foot orthosis function in sagittal plantar flexion resistance affected the alignment of the upper body and the pelvis during the gait of stroke patients in the subacute phase . Clinical relevance Maintaining upright posture is important in gait rehabilitation . The findings of this study suggest that the ankle – foot orthosis with plantar flexion resistance facilitated better alignment of the upper body and pelvis during the gait of stroke patients in subacute phase . This type of ankle – foot orthosis could be beneficial for patients with malalignment of the upper body and pelvis
Objective : The aim of this study was to evaluate the effects of ankle-foot orthoses on speed walking in patients with stroke .