ANKLE FOOT ORTHOSIS ALTERS GAIT CHARACTERISITCS IN PAITENTS WITH PERIPHERAL ARTERY DISEASE

Research Objectives: To investigate the acute and long-term effect of using ankle foot orthoses (AFOs) on spatiotemporal gait parameters of patients with peripheral artery disease (PAD).

Design: In a cross-over designed study, subjects were randomized into control and AFO groups. Patients in the AFO group wore bilateral AFOs each day for three months while the control group followed the standard of care for the first three months. Both groups returned for a second evaluation, “crossed over” to the other group for three months, then returned for a final assessment.

Setting: Patients with PAD were recruited from the claudication clinic at Omaha VA Medical Center.

Participants: Twenty-one patients with PAD completed all required study visits. Participants had no walking limitations except claudication and related systemic pathology.

Interventions: Patients were instructed to wear bilateral AFOs at all times except in bed and showering during AFO intervention.

Main Outcome Measures: Means and standard deviations (variability) of spatiotemporal gait parameters (step velocity, step length, step time, and step width) were calculated from motion capture analysis while patients were walking at their preferred speed overground with and without AFOs (NAF).

Results: While wearing AFOs, patients with PAD had increased step time compared to the NAF condition (p=0.03). However, after a three-month intervention with AFOs, step time decreased (p=0.04), indicating that the AFO intervention had a beneficial effect on gait adaptation. The AFO group preserved the amount of step width variability following three months of intervention, however, the control group experienced a reduced amount of step width variability (p=0.001) when walking without the AFO. The amount of variability of step length (p=0.02) and step velocity (p=0.03) were reduced at the three-month visit compared to baseline.

Conclusions: These changes indicate the stepping pattern moved closer to healthy controls after three months of an AFO intervention.

Author(s) Disclosures: All authors declare they have no conflict of interest.