Immediate Effects of Walking Training With Elastic Ankle Support Devices on Walking and Mobility of Ambulatory Individuals With Stroke

Objective: To compare the immediate effects of walking training without or with an ankle support device (ASD) on spatiotemporal gait parameters, mobility, and satisfaction among 20 ambulatory participants with chronic stroke. Methods: This crossover design required the participants to complete the four 30-minute walking training conditions in a randomized order: without ASD, with ankle-foot orthosis (AFO), with long ankle sling made from 3- to 4-inch elastic bandage, and with elastic ankle support equipment (EASE) developed from elastic bands with buttonholes and plastic rivets, with a 7-day washout period. Gait parameters and Timed Up and Go test (TUG) were measured before and after each training program, and satisfaction with the three ASDs was assessed upon completion. Results: Spatiotemporal parameters (except walking cadence and symmetry) and TUG after training with a long ankle sling and EASE were significantly better than those following training without ASD and with AFO (p<0.001). Participants satisfied with both elastic ASDs in terms of dimensions, weight, safety, comfort, and effectiveness (p<0.001). The EASE was also satisfied for its ease of application and adjustment. The AFO was durable and easy to use but heavy, uncomfortable, and unsafe. Conclusion: The elastic ASDs were designed to assist ankle movements during the stance and swing phases. Thus, they improved walking and mobility of the participants significantly greater than the training with AFO and without ASD. The findings suggest the use of a long ankle sling and EASE as an alternative ASD to promote mobility of ambulatory individuals with chronic stroke.