Comparison of the effects of solid versus hinged ankle foot orthoses on select temporal gait parameters in patients with incomplete spinal cord injury during treadmill walking

Abstract

Ankle foot orthoses (AFOs) are usually used for patients with incomplete spinal cord injury (ISCI) to provide support in walking. The aim of this study was to compare the effect of AFOs, with and without ankle hinges, on specific gait parameters during treadmill training by subjects with ISCI. Quasi-experimental. Five patients with ISCI at the thoracic level participated in this study. Gait evaluation was performed when walking 1) barefoot 2) wearing a solid AFO and 3) wearing a hinged AFO. The mean step length when walking barefoot was 26.3 ± 16.37 cm compared to 31.3 ± 17.27 cm with a solid AFO and 28.5 ± 15.86 cm with a hinged AFO. The mean cadence for walking barefoot was 61.59 ± 25.65 steps/min. compared to 50.94 ± 22.36 steps/min. with a solid AFO and 56.25 ± 24.44 steps/min with a hinged AFO. Significant differences in cadence and step length during walking were only demonstrated between the barefoot condition and when wearing a solid AFO. Significant difference was not observed between conditions in mean of ankle range of motion. The solid AFO was the only condition which improved cadence and step length in patients during ISCI gait training. Clinical relevance A solid AFO could be used permanently to compensate for impaired ankle function or it could be used while retraining stepping.