If certain neuronal functions have been lost due to a stroke, these can be taken over by unaffected areas of the brain. This process of creating new nerve connections is called neuronal plasticity. The trigger for this process is the repeated training of the impaired functions, which should start as soon as possible after the stroke. In particular, if neuronal functions are impaired that are responsible for balance and muscles for safe standing and walking, both stance and gait training must be started very early. Both require the early use of the right medical devices. Without an orthosis, training can be very laborious for both the therapist and the patient. Therefore, standing and walking are often integrated into the treatment regimen too late or too little. This can already be started in early rehabilitation if a custom-made orthosis is produced for the affected leg immediately after the stroke. Unfortunately, the importance and potential of the right orthosis for the course of therapy, as well as the assistance that an orthosis provides for therapists and attending personnel, is often underestimated or not even recognised. Patients who have suffered a stroke and are now treated with an orthosis share their experiences.
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The Altered Pathological Gait Affects the Whole Body:

• lack of safety when standing and walking
• balance difficulties
• too little exercise for the muscles
• development of deformities

Impairments caused by a stroke can be reduced or eliminated with the help of an orthosis. For instance, an orthosis supports the patient in relearning how to stand and walk physiologically. Moreover, the risk of secondary damages due to a pathological gait is reduced. Combined with physiotherapy/occupational therapy, a gait can be achieved that allows the patient to feel safe on their feet again. Not having to stumble or fall down anymore creates a sense of security and self-confidence. Thus, an orthosis contributes to an early mobilisation of the patient. In most cases, it makes sense to provide the patient with a custom-made ankle-foot orthosis. Such an orthosis is also called AFO. The term AFO (ankle-foot orthosis) refers to the body parts included in the orthotic treatment: ankle and foot.

An orthosis with individual functional elements affects different levels:

• support of the paralysed calf muscles (plantar flexors) for more safety while standing and walking
• support of the paralysed shin muscles (dorsal flexors) to prevent tripping
• balance support thanks to functional elements with precompressed spring units

Through these three functions, the orthosis helps the muscles establish the correct cerebral connections through motor impulses. A cerebral connection is the control programme that the brain stores in order to be able to execute complex movement patterns.