A Comparative Study of Performance of Anterior Ankle Foot Orthosis (A-AFO) vis-à-vis. Posterior Ankle Foot Orthosis (P-AFO) in Terms of Gait Parameters and Energy Expenditure in Hemiplegic Patients with Foot Drop

Background: Ankle-Foot Orthosis (AFO) has been used for hemiplegic patients for several decades to provide plantarflexion resistance during the stance phase and prevent toe dragging during the swing phase. The Anterior Support Ankle Foot Orthosis (A-AFO) represents a novel orthotic management intervention. However, research is scarce contrasting the biomechanical efficacy of A-AFO and Posterior Support Ankle Foot Orthosis (P-AFO). This study aimed to assess the efficacy of A-AFO compared to P-AFO in hemiplegic patients with foot drop, utilizing gait analysis and physiological cost index (PCI). Methods: This crossover study included hemiplegic foot drop patients who could walk with or without an orthosis. Patients with spasticity greater than grade 2, as assessed by the Modified Ashworth Scale, were excluded. The physiological cost index was measured to calculate energy expenditure. Along with evaluating various gait parameters, a questionnaire about the patient’s preference after four weeks was also administered. Results: A-AFO was significantly better than P-AFO in terms of PCI and various gait parameters. Conclusions: A-AFO should also be recommended because it is similar to P-AFO in terms of gait parameters and energy efficiency. Key words: Hemiplegia, Ankle Foot Orthosis, Energy Expenditure, Foot Drop, Gait Analysis, Orthotic devices