A Comparison between the Immediate Effects of Hip Flexion Assist Orthosis and Conventional AFO on Gait Parameters in Ambulatory Multiple Sclerosis Patients

Abstract

Abstract Introduction: Multiple Sclerosis (MS) is an autoimmune disease which affects the skeletal muscles and optical neural networks. Weakness of ankle dorsi flexion and hip flexion muscles is commonly seen in consequence MS. The Ankle Foot Orthosis (AFO) is the most frequently prescribed orthoses to compensate for these weaknesses. It is generally believed that patients are commonly dissatisfied with AFOs. Hip Flexion Assist Orthosis (HFAO) is an orthosis which has been developed to address the shortcomings of the conventional AFO while it is neither manufactured nor prescribed in Iran earlier than the current study. Materials and Methods: Seventeen ambulatory MS patients with unilateral lower extremity flexor weakness were participated in this study. Gait parameters including speed and step symmetry were evaluated after the Two Minute Walk (2MW) test with and without AFO and HFAO interventions. The relation between BMI and the orthoses effectiveness was evaluated while and the participants` satisfaction was assessed by means of a valid questionnaire. Results: The average speed of walking and step symmetry was improved while using HFAO (P<0.001). The level of satisfaction was also significantly higher with HFAO. No significant relationship was found between the effect of BMI and effectiveness of the interventions. Conclusion: The results of the evaluations of this study indicate that the HFAO immediately improves step symmetry and increases speed of walking in MS patients with hip flexors and ankle dorsiflexors weakness. It seems the BMI is not a determining factor in prescription of this orthosis. Keywords: Multiple Sclerosis, MS, Orthosis, HFAO, AFO