ArticleGait & posture2022
Investigating the underlying biomechanical mechanisms leading to falls in long-term ankle-foot orthosis and functional electrical stimulator users with chronic stroke.
Article in Gait & posture, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 13 citations in OpenAlex.
- The Role of Functional Electrical Stimulation in Stroke Rehabilitation: A Preliminary Study.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2025Trial
- Soft vs. Traditional AFOs: A Comparative Study on Gait Kinematics, Kinetics, and Muscle Activity.Restorative neurology and neuroscience · 2026Article
- Dorsiflexion Specific Ankle Robotics to Enhance Motor Learning After Stroke: A Preliminary Report.Research square · 2024Article
- Effects of ankle-foot orthoses on gait parameters in post-stroke patients with different Brunnstrom stages of the lower limb: a single-center crossover trial.European journal of medical research · 2024Article
- The Effect of Diagonal Exercise Training for Neurorehabilitation on Functional Activity in Stroke Patients: A Pilot Study.Brain sciences · 2023Article
- Research and Development of Ankle-Foot Orthoses: A Review.Sensors (Basel, Switzerland) · 2022Review
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAnkle-foot-orthoses (AFOs) and functional electrical stimulators (FES) are commonly prescribed to treat foot-drop in individuals with stroke. Despite well-established positive impacts of AFO and FES devices on balance and gait, AFO and FES-users still fall at a high rate.
objectiveThe objective of this study was to investigate 1) the underlying biomechanical mechanisms leading to a fall in long-term AFO and FES-users with chronic stroke and 2) the impacts of AFOs and FES devices on fall outcomes and compensatory stepping response of long-term users with chronic stroke.
methodsFall outcomes as well as kinematics and kinetics of compensatory stepping response of 42 individuals with chronic stroke (14 AFO-users, 10 FES-users, 18 Non-users) were evaluated during trip-like treadmill perturbations. AFO and FES-users were evaluated with and without their device.
resultsChronic AFO and FES-users fell 2.50 and 2.77 times more than Non-users. The most robust differences between AFO/FES-users and Non-users were 1) Reduced capacity to stabilize the trunk through reduction in forward whole-body angular momentum and 2) diminished capability to prepare and generate a second step using the paretic leg. Provocatively, the removal of AFO and FES devices did not decease/increase falls or change kinematics. SIGNIFICANCE: It is well-established that AFOs/FES devices have a positive impact on static balance and decrease community falls by increasing toe clearance thus preventing trips/stumbles. However, our results suggest that once a trip occurs, these devices do not adequately assist recovery of balance. Specifically, current AFO and FES devices do not assist with second step generation or trunk control. Future studies should explore new devices or training paradigms that target enhancing trunk control and paretic compensatory stepping to decrease falls in this population.
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