Ankle-Foot Orthoses in Spinal Cord Injury: Systematic Review of Literature

Background: Spinal cord injury patient present gait abnormality, and this can compromise physical and mental health. Ankle- Foot Orthosis are the most used orthoses in the walking rehabilitation of these patients. Aim: The aim of this review was to overview types, characteristics, function and efficacy of ankle-foot orthosis in the rehabilitation of SCI patients, based on the literary EBM. Methods: A systematic review was conducted throught a clinical query based on PICO method. Studies were identified in Pubmed, MEDLINE, ISI Web of Knowledge, EDS Base Index, PEDro, NARCIS database. PRISMA Statement was used to report results, and Newcastle-Ottawa Castle was used to assess quality of the articles. Results: The review included five cohort studies. Four studies used hinged AFOs and compared them with other orthoses for the walking rehabilitation of SCI patients. Two studies concerned powered AFOs, and two other ones combined them with other rehabilitation devices. According to the Newcastle-Ottawa Scale, all studies scored 6/7 and 7/7. Discussion: Hinged AFOs provided the best performance and effective devices, especially in the rehabilitation context. Powered AFOs are innovative orthoses with a great evaluative, therapeutic and prognostic value. They can promote recover of walking ability in SCI patients. A comprehensive rehabilitation programme, using hands-on techniques, aids and orthoses together with AFOs is effective and better than the single use of a device