An ankle-foot orthosis with inhibitor bar: Effect on hemiplegic gait

Objective: To test whether an inhibitor bar attached to an ankle-foot orthosis (AFO) improves walking ability in hemiplegic stroke patients with tonic toe flexion reflex (TTFR). Design: Before-after trial. Setting: Rehabilitation hospital in Japan. Participants: Nine patients with TTFR were assigned to the TTFR group, and 8 patients without TTFR were assigned to the control group. Intervention: Inhibitor bar attached to an AFO. Main Outcome Measure: Gait was analyzed by measuring the number of steps and the time required to walk 10m at a maximal walking speed. Results: In the TTFR group, use of an inhibitor bar for 2 weeks significantly increased the maximal walking speed, stride length, and cadence by 13.8% (P=.0045), 8.0% (P=.0398), and 6.1% (P=.0056), respectively. There were no significant changes in the control group. Conclusion: An inhibitor bar improved walking ability of hemiplegic patients with TTFR, and its use with an AFO is recommended. (C) 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.