Functional wal;ing disability due to abnormal reafoot biomechanics after stroke and the effects of a new modified ankle-foot orthosis to improve such functional consequences

Srtok is the leading cause of adult disability and ~50% of people with stroke suffer foot deformities which influence walking. The aim of this study was to investigate functional walking disability due to abnormal rearfoot biomechanics in people with stroke and explore the effects of a modified ankle-foot orthosis to improve such functional consequences. Stance phase rearfoot biomechanics were quantified using a multisegment foot model on the affected side of twenty stroke subjects. The stroke subjwcts were categorised into two groups according to their walking ability; either household (45%, n=9) or community walkers (55%n=11). The results of Wald statistics of the logistic regression models revealed that Stroke subjects with greater pressure on medial heel (odds ratio=1.11), less plantarflexedrearfoot (odds ratio=1.30) or inverted rearfoot (odds ratio=1.70) at toe off or less range of rearfoot adducion in late stance (odds ratio=0.65) were more likely to be household walkers. The coefficient of determination of models (Pseudo R-Square) indicated that final regression models explained 29%-46% of variance in the stroke group s functional walking ability. The work also investigated the effects of freedom of movement of the Subtalar joint in a new modified ankle-foot orthosis on walking speed and mobility function. This new modified ankle foot orthosis (Rfafo) was designed by cutting the lower posterior ankle foot orthosis to release the rearfoot. The 10 healthgy subjects (5 males and 5 females with mean age of 22.1±2.86 years) participated in this study The use of the RFafo orthosis statistically improves speed of walking in the six minutes walking lest, improves the range and pattern of rearfoot motion, and improves the ankle function during the stance phase of the gait compared to converntional solid afo: without causing a disruption to the main function of the orthosis.