The Effects of a Dorsiflexion-Stopped Ankle-Foot Orthosis on Walking in Individuals with Incomplete Spinal Cord Injury

After incomplete spinal cord injury, the plantar flexor (PF) muscles commonly are weakened, compromising forward progression of body weight over the foot. One means of counteracting this deficit is by the use of an ankle-foot orthosis (AFO). Some clinicians have hesitated to prescribe an AFO, concerned that its use reduces PF activity and limits strength improvements. The purpose of this study was to determine the effect of a dorsiflexion-stopped AFO on walking characteristics following incomplete spinal cord injury with PF weakness. Walking patterns were compared for nine individuals walking in an AFO and in shoes. Use of an AFO significantly increased gait velocity, lengthened stride length, and improved stance knee position without altering muscle activity patterns in the calf or quadriceps. These results suggest that use of a dorsiflexion-stopped AFO improved walking patterns without hampering muscle activity.