Early or delayed provision of an ankle-foot orthosis in patients with acute and subacute stroke: A randomized controlled trial
- Authors: Corien D.M. Nikamp1,2, Jaap H. Buurke1,2,Job van der Palen2,3,Hermie J. Hermens1,2,Johan S. Rietman1,2,4
1 Roessingh Research and Development, Enschede, The Netherlands
2 University of Twente, Enschede, The Netherlands
3 Medisch Spectrum Twente, Enschede, The Netherlands
4 Roessingh Centre for Rehabilitation, Enschede, The Netherlands
Summary: For determining the importance of an early orthotic treatment for gait rehabilitation after a stroke, 33 patients with acute or subacute stroke were provided with a simple ankle-foot orthosis. The patients were randomly divided in an early- (average of 32 days after the stroke) and a delayed-treated group, who received their orthoses eight weeks after the early-treated group. Over a period of eleven weeks, the outcome was measured at four specific points in time using eight functional tests.
Directly after the provision of the orthoses, all parameters improved in the early-treated and most parameters improved in the delayed-treated patient group. In the first three weeks, the short term effects of wearing an orthosis were larger compared to the natural recovery without orthosis during the same time. With the early provision, walking speed and balance were significantly improved during that period. This result is considered to be clinically relevant. When comparing the general outcome after eleven weeks, an early provision of an orthosis tends to have positive effects on balance, activities of daily living and walking abilities. In conclusion, the early provision of an ankle-foot orthosis is beneficial for restoring independent gait in patients with acute and subacute stroke.
Keywords: AFO, ankle-foot orthosis, AFO, stroke rehabilitation, functional outcome, timing of provision, randomized controlled trial