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Ankle Foot Orthosis in SCI

Table 3: Prevention of AD during Bladder Procedures

Author Year; Country
Score
Research Design
Sample Size
MethodsOutcomes
Kim et al. 2004

Canada

PEDro=5

RCT

Level 2

N=19

Population: 19 participants with incomplete SCI who had dropfoot but were able to walk independently

 

Treatment: Randomized to conditions of AFO, no AFO, FES and FES and AFO. They walked at their self-selected speed along a flat walkway.

 

Outcome Measures: Walking speed and 6MWT

1.     Gait speed increased 7.5% from 0.4 m/s (no orthosis) to 0.43 (AFO)

2.     6 Minute Walk Test increased 16% from 138 to 160 m

Arazpour et al. 2013

Iran

PEDro=4

RCT

Level 2

N=5

Population: 5 participants with incomplete SCI (thoracic lesion)

 

Treatment: Gait evaluation while walking with 1) no shoe; 2) solid AFO and 3) hinged AFO

 

Outcome Measure: Step length, cadence

1.     Solid AFO improved step length from 28.5 from 26.3 cm and cadence from 52 to 62 steps/minute.

2.     No significance differences between the no shoe and hinged AFO condition.

 

Discussion

Both these studies (Kim et al., 2004; Arazpour et al., 2013) examined the immediate effects of an ankle-foot-orthosis after randomizing different brace conditions. Positive effects consisted of increased gait speed, step length, cadence and improved performance on the 6 Minute Walk test. These are not typical experimental designs for an RCT as all the conditions were assessed within one single session rather than allowing participants to accommodate 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.

Conclusion

There is level 2 evidence (Arazpour et al. 2013; Kim et al. 2004) that an ankle-foot-orthosis can enhance walking function in incomplete SCI patients who have drop-foot.

  • Ankle-foot-orthosis can enhance walking function in incomplete SCI patients who have drop-foot.