A review of the effect of a Walker ankle-foot orthosis on gait biomechanics in healthy individuals

Abstract

Walker orthoses are one of the most popular substitutes to regular cast. They are used by people who have experienced acute trauma to the ankle complex. This review aimed to summarize and update information on the currently published research explicitly related to the application of ankle-foot orthoses and to help improve the understanding of how orthoses influence gait pattern, in particular the kinematics, kinetics, and muscle activity parameters. A review of papers published from 1999 to 2019 was conducted. The databases searched included PubMed Central, PubMed, ScienceDirect and EBSCO, a total of 546 articles were found. The review is based on 11 articles that were selected for further analysis. Kinematics parameters were described in 8 papers, kinetics parameters in 6 papers, the effect of a Walker orthosis on muscle activity in 2 papers, and the effects of a Walker boot on energy cost, pain and balance were discussed in 3 papers. A Walker orthosis significantly reduces ankle joint motion and significantly reduces lower leg muscle activity. On the other hand, it may cause secondary site pain due to leg length differences and increase in energy expenditure. A Walker orthosis is a useful tool replacing total contact casts and allowing earlier weight bearing and rehabilitation. It is important to use it for the shortest possible period of time and to always use compensation of leg length discrepancy.