Effect of a tone-inhibiting dynamic ankle-foot orthosis on stride characteristics of an adult with hemiparesis

A single-subject, alternating-treatment design was used to investigate differences in stride characteristics of a hemiparetic subject under three conditions: 1) barefoot, 2) using a prefabricated plastic molded ankle-foot orthosis (AFO), and 3) using a tone-inhibiting dynamic ankle-foot orthosis (TIAFO). Five barefoot baseline sessions were conducted. Following these baseline sessions, the three conditions were randomly varied during each of 12 alternating-treatment sessions. Data analysis revealed a significant improvement in walking velocity, step length, and stance time on the hemiparetic limb and a significant decrease in cadence when either the AFO or the TIAFO condition was compared with the barefoot condition. The TIAFO was associated with a significant increase in walking velocity and step length when evaluated against the prefabricated AFO. The subject reported that use of the TIAFO increased his ability to ambulate distances and that the TIAFO was more comfortable and less restrictive than the prefabricated AFO. The results suggest that the TIAFO may be a promising alternative to conventional orthotic management of adults with hemiparesis.