Static ankle-foot orthosis improves static balance and gait functions in hemiplegic patients after stroke

The purpose was to examine the effects of static anterior and posterior ankle-foot orthoses (AAFOs & PAFOs) using with regular shoes on improving static and gait function in patients recovering from stroke. Static and dynamic balance control were measured under four conditions: barefeet, wearing regular shoes only, and wearing regular shoes with AAFOs or PAFOs. The results indicated that wearing regular shoes markedly increased the center of pressure (CoP) sway (p < 0.05) in static standing conditions. Both AAFOs and PAFOs decreased CoP sway and increased bilateral limb loading symmetry compared to barefoot and wearing shoes alone (p < 0.05). PAFOs decreased CoP sway more than AAFOs (p > 0.05) and also boosted medial-lateral weight shifting more effectively (p < 0.05). Both types of AFOs increased walking efficiency but influenced the roll-over shape of the CoP adversely during level walking. The conclusions are that both AAFOs and PAFOs improved static and dynamic balance control when they were used with regular shoes and PAFOs appeared to be more efficient than AAFOs. Shoes worn daily with AFOs is a key consideration influencing balance control in stroke patients. However, AFOs with static design impeded the function of the three rocker systems of the foot during ambulation.