AbstractBackgroudAnkle foot orthoses (AFOs) have been widely used in stroke patients to assist in safe, energy efficient walking. Since they provide mediolateral ankle stability during stance, adequate toes clearance during swing phase and also facilitation of heel strike.ObjectiveTo compare the efficacy of anterior or posterior plastic ankle foot orthoses (AFOs) for ankle spasticity.MethodsCrossover design with randomization for the interventions, blinded assessors was used. 20 patients with

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... ronic stroke, Modified Ashworth scale (MAS) of ankle ≤ 2 and Tardieu angle ≥ 20 degrees. The participants were random to treat with anterior or posterior plastic AFOs and then were crossover to treat with the other one. Outcomes measurement was performed by using passive range of motion (PROM), MAS, walking velocity, stretch reflex surface EMG and walking surface EMG of medial gastrocnemius muscle. Patient satisfaction was evaluated at 1 month.ResultsTwenty stroke patients with ankle spasticity were recruited. Mean age was 46.60(38-60) years old.Mean duration. of times since stroke was 9.35 (6-15) months. Comparison between two types of orthoses revealed statistically significant improvement of walking surface EMG of medial gastrocnemius muscles when using anterior plastic AFO more than posterior plastic AFO at p=0.015. Patients satisfaction were statistically significant higher when using anterior plastic AFO more than posterior plastic AFO at p<0.05.ConclusionAnterior plastic AFO has more efficacy in reduced dynamic ankle spasticity during walking than posterior plastic AFO proven by comparison the dynamic electromyography changes in dynamic spasticity during walking.