Effects of ankle-foot orthoses on step activities in the community: a systematic review

Abstract

Purpose To determine the effects of ankle-foot orthoses (AFO) on step-based physical activities in individuals with neurological, orthopaedic, or cardiovascular disorders. Methods Electronic searches of databases such as Scopus, PubMed, Web of Science, Embase, ProQuest, Cochrane Library, and EBSCO were conducted. Two evaluators independently searched with keywords focusing on step-based physical activities, and either articulated or non-articulated AFO. Study quality was assessed using a modified Downs and Black quality scale. Results Eleven studies that met the inclusion criteria were selected, including four being classified as good, four as fair, and three as poor in quality. The majority of these trials found no significant effects of AFO on step activities. Only a few studies reported improvements in step counts and active times in step activity with a limited to moderate level of evidence. Subjective evaluations such as user satisfaction, and physical functionality during step activity, on the other hand, showed substantial changes with the use of AFO interventions, although there was no evidence of improvement in the quality of life. Conclusions Although the AFO did not seem to have a substantial effect on step activity, it appeared to play a vital role in improving the patient satisfaction level of step activity. IMPLICATIONS FOR REHABILITATION Ankle-foot orthoses (AFO) may not significantly affect the step activity of individuals with impaired ankle-foot complex. AFO may enhance patient-reported satisfaction, physical functioning, participation, and fatigue level during step activity. The patient’s perception that the AFO is beneficial is in contrast to objective data showing no significant increase in real-world activity.