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

Background: Ankle foot orthoses (AFOs) are usually used for patients with incomplete spinal cord injury (ISCI) to provide support in walking. Objectives: 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. Study Design: Quasi-experimental. Methods: 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. Results: 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. Conclusion: The solid AFO was the only condition which improved cadence and step length in patients during ISCI gait training.