AFO Prescription to Optimize Post-Stroke Function

The Development of Patient-Centered Clinical AFO Prescription Guidelines to Optimize Post-Stroke Function and Quality of Life

The overall goal of this study is to attain the highest possible health-related quality of life for individuals with lower-limb impairment through a clinical trial examining three different modern carbon fiber ankle-foot orthosis (AFO) treatment options targeting the rehabilitation of individuals post-stroke. To achieve this goal, the investigators will:

1. Identify the factors that significantly contribute to an individual's highest potential quality of life when considering each of the three available AFO design options, and
2. Develop prediction models of clinical performance using biomechanical function linked to the three AFO designs.

Participants will be asked to:

• Wear each of the three modern AFO designs for one month, after receiving therapy training and
• Complete questionnaires and performance tests with each AFO.

In addition, the subset of individuals participating in goal 2) will also be asked to:

• Perform biomechanical analyses using high-speed cameras and force plates during different walking and balance tests with each AFO design.

Inclusion Criteria:

• be a minimum of three months post-stroke
• be greater than 18 years of age
• have been prescribed either a semi-rigid or a custom-made articulating AFO
• wear their prescribed AFO for all primary mobility activity outside the house
• be able to walk at least 20 meters without manual assistance
• walk at least 10 meters per minute (12% of normal velocity) during a 6-meter self-selected velocity walking test.

Exclusion Criteria:

• having a condition that could significantly limit ambulation, including severe osteoarthritis, rheumatoid arthritis, congestive heart failure, or pre-existing neurological disorder other than post-stroke
• having cognitive deficits that preclude their ability to provide consent for participation
• having an ankle plantar flexion contracture equal to or greater than 15 degrees plantar flexion with full knee extension