Ankle Foot Orthosis in SCI

Discussion

Because bracing devices are used widely by clinicians, and often seen as simple assistive devices for improving walking function or stability and limiting pain, there are very few studies actually researching the benefits.

Both studies we found (Kim et al. 2004; Arazpour et al. 2013) examined the immediate effects of an AFO after randomizing different brace conditions. Positive effects consisted of increased gait speed, step length, cadence and improved performance on the 6MWT. These are not typical experimental designs for an RCT, as all the conditions were assessed within one single session rather than allowing participants to adapt to different brace conditions over several weeks or sessions. However, it is generally recognized in the clinical field that effects from an AFO are attained immediately, although it is likely that practice over a few sessions may improve a person’s confidence, learning and function.

Conclusions

There is level 1 evidence (from 2 RCTs: Arazpour et al. 2013; Kim et al. 2004) that an AFO can enhance walking function in patients with incomplete SCI who have drop-foot.