Physical and functional correlations of ankle-foot orthosis use in the rehabilitation of stroke patients

Objective: To examine factors associated with the use of ankle-foot orthose s (AFOs) in stroke patients undergoing rehabilitation. Design: Retrospective cohort study of the frequency of AFO use. Setting: Inpatient rehabilitation unit. Participants: Consecutive stroke patients (n = 423) admitted to an inpatien t rehabilitation unit over a 10-year period. Intervention: Discharge with AFO. Main Outcome Measures: Functional outcome measurement scores of patients wh o were and who were not prescribed an AFO were examined. The groups were co mpared by using admission and discharge Chedoke-McMaster Stroke Impairment Inventory (CM; each measure analyzed separately), FIM(TM) instrument (walki ng" stairs, overall measures), and Berg Balance Scale scores. Results: Ninety-three of the 423 patients (22%) were discharged with an AFO . Overall, they scored consistently lower than patients who were discharged without an AFO. Statistically significant differences (p <.001) were noted between AFO users and nonusers in admission and discharge scores in the ar m, hand, leg, and foot components of the CM and the FIM stairs and walking component scores. Average admission and discharge Berg scores differed betw een the 2 groups (p =.005, p =.013, respectively). Overall FIM scores were also significantly different both at admission and discharge (p <.001, p =. 025, respectively). Conclusion: Use of AFOs at discharge was associated with significantly lowe r admission and discharge CM scores of the arm, hand, lea, and foot; FIM wa lking and stairs scores; total FIM scores; and Berg Balance Scale scores.