Objectives.- To evaluate in chronic walking hemiparetic subjects the efficacy regarding the correction of the knee recurvatum and the walking performances of a lowered dynamical ankle-foot orthosis (D-AFO) in comparison with a prefabricated ankle-foot orthosis (P-AFO, OttobockTM) and shoes alone (SH). The secondary objective was to evaluate the satisfaction of the patients, with a focus on the putting of the orthosis and the shoes. Methods.- The D-AFO is a carbon individually made orthosis, with a lowered articulation. Twenty chronic hemiparetic walking subjects were included in this single center comparative study. Gait quality was assessed on a GaitRite treadmill with a video recording performed with the D-AFO as compared to the P-AFO and shoes alone. The walking performances were assessed with a six minutes walking test and a Wade test with the D-AFO versus the P-AFO. The satisfaction was assesses with the ESAT-QUEST. Results.- Walking with the D-AFO shows a significant improvement of the speed and quality of the gait as compare to shoes alone (walking time: 16.7 s null 11 s versus 21.9 s null 17 s, P = 0.04; FAP: 64 null 18 versus 59 null 16, P = 0.0018). The mean walking time and FAP are better with the D-AFO than with the P-AFO, but the statistical comparison doesn't reach significance. The D-AFO allows a better quality and a better control of the knee recurvatum as compare to the P-AFO, and is also associated with a high level of patients 'satisfaction (ESAT-QUEST 43 null 6/50). Conclusion.- In a population of chronic walking hemiparetic patients with a knee recurvatum problem, the lowered D-AFO improves the gait quality and walking performances comparatively to a P-AFO and shoes alone. It is also associated to a high level of patients' satisfaction especially regarding the putting of the orthosis and the shoe.
Perrin, C., Condemine, A., & Giraux, P. (2012). Efficacy and satisfaction of a lowered dynamical ankle-foot orthosis in chronic walking hemiparetic subjects. Annals of Physical and Rehabilitation Medicine, 55, e108. https://doi.org/10.1016/j.rehab.2012.07.285