Currently, it is still far too common to refrain from orthotic treatment in the acute phase of a stroke, as it is difficult to assess the required support for safe stance and gait.

Therefore, a conclusive muscle function test may not be possible and a gait type cannot be determined. However, since early fitting is crucial, this configuration option enables you to plan a treatment even without a determination of the muscle strength. The resulting AFO with dynamic dorsiflexion and plantar flexion stop can be adjusted to the patient's individual requirements during subsequent gait training.

Stance Training as Preparation for Gait Training

Before walking comes standing. Even though standing still is perceived as a simple motor task, it involves the same muscle groups as walking. Dynamic orthoses are a valuable support for a safe stance after a stroke and can prevent or reduce the appearance of spastic pareses. Although the patient might not be able to put on the orthosis themself, stance training should already begin in the acute phase.

This early stance training offers the following advantages:

• The recovery of the sense of balance is stimulated.
• Bringing the body into an upright position (verticalisation) has a variety of positive effects on the human organism.
• The controlled load on the muscles can reduce the time to regain independent walking.
• Standing in the acute phase can establish the correct cerebral connections through motor impulses.

Furthermore, a stance training in this early phase of rehabilitation supports the prevention of pes equinus as the muscles are stretched and loaded dynamically. Additionally, the orthosis also prevents that the foot is in a permanent quinus position when lying in bed.

In addition to the expansion of the physical examination for patients with stroke in the acute phase in the Orthosis Configurator, other parts of our website have been updated, such as the Orthotic Treatment Sheet for Stroke Patients (apoplexy) . You can now record the physical examination for an AFO according to N.A.P.® Gait Classification, for an AFO/KAFO according to the physical examination or an AFO based on patient data (acute phase).

The online tutorial “Physical Examination following a Stroke also addresses this option with “Physical Examination Option 1: Treatment in Acute Phase”. For a quick start to the patient's stance and gait training, an entry orthosis is recommended that allows a subsequent adjustment to the respective gait type.

You can find out more about stroke under Indications and Clinical Pictures.

Do you have any questions about the treatment in the acute phase? To do so, please contact our Technical Support under +49 4131 24445-0 or support(at)fior-gentz.de.