Role of ankle foot orthosis in improving locomotion and functional recovery in patients with stroke: A prospective rehabilitation study

Challenge Level Contributes to the Efficacy of Treadmill Interventions after Stroke: A Systematic Review and Meta-Analysis

Intervention parameters such as the challenge, amount, and dosage (challenge × amount) have the potential to alter the efficacy of rehabilitation interventions after stroke. This systematic review investigated the effect of intervention parameters of challenge, amount, and dosage on improvements in walking outcomes following treadmill training (TT) and comparison interventions in people with stroke. Randomized controlled trials were included if they: (i) investigated interventions of TT or bodyweight-supported TT (BWSTT); (ii) made comparisons with other physiotherapy interventions, other types of TT, or no intervention; (iii) studied people with stroke; (iv) reported sufficient data on challenge and amount parameters; and (v) measured walking speed or endurance. Completeness of reporting was evaluated using the TIDieR-Rehab checklist and risk of bias was assessed using the revised Cochrane risk-of-bias tool. The review included 26 studies; 15 studies compared TT or BWSTT with other physiotherapy interventions and 11 studies compared different types of TT. Meta-analyses provided evidence with low to moderate certainty that greater differences in challenge and dosage between treadmill and comparison physiotherapy interventions produced greater effects on walking endurance (p < 0.01). However, challenge and dosage did not influence walking speed outcomes. The analysis of intervention amount was limited by the lack of studies that manipulated the amount of intervention. Overall, the findings indicate that, after stroke, some of the efficacy of TT on walking endurance can be explained by the challenge level during training. This supports the implementation of TT at higher challenge levels in stroke rehabilitation practice.

The effect of a modified elastic band orthosis on gait and balance in stroke survivors

BACKGROUND

Gait is crucial for independent living for stroke survivors and assistive devices have been developed to support gait performance. Ankle foot orthosis (AFOs) are commonly provided to stroke survivors to prevent foot drop during walking. However, previous studies have reported limitations of AFOs including them being too heavy, creating skin irritation, and being a stigma of disability.

OBJECTIVE

The purpose was to compare the gait and balance improvement between elastic band orthosis (EBOs) and AFOs.

STUDY DESIGN

Experimental study design.

METHODS

The AFOs and EBOs were provided to 17 stroke survivors, and changes in gait and balance were assessed compared to barefoot (control). Gait spatiotemporal parameters were measured using the zebris-FDM-Rehawalk® system, and balance ability was evaluated using the time up and go test (TUG). Satisfaction with the EBOs was determined using the Quebec user evaluation of satisfaction with assistive technology (QUEST2.0) questionnaire.

RESULTS

The EBO showed significant differences in; gait speed, cadence, stride length, stride time, step length unaffected side, stance phase and swing phase on the affected side, and pre-swing on the unaffected side, and balance performance (TUG) (p<0.05) when compared to the AFO and control conditions. The participants were quite satisfied with the EBOs with QUEST2.0 scores greater than 4 out of 5.

CONCLUSIONS

EBOs could be provided to stroke survivors given their acceptability and properties to improve gait and balance. The EBO used in this study offered clinically important improvements in gait and balance when compare to AFO and control conditions, and could mitigate against some of the limitations reported in the use of AFOs in stroke survivors.

Efficacy on gait and posture control after botulinum toxin A injection for lower-limb spasticity treatment after stroke: A randomized controlled trial

Objectives

To observe the efficacy of botulinum toxin type A (BoNT-A) for the spasticity of the lower-limb post-stroke on gait and posture control.

Methods

A total of 46 patients with hemiplegia gait were randomly divided into the experimental group (23 patients) and the control group (23 patients). In patients in the experimental group received injections of BoNT-A by electrical stimulation-guided. At the same time, patients of the two groups received routine physical therapy. Gait analysis, plantar pressure analysis, lower-limb Fugl-Meyer assessment (L-FMA), 10 meter walking test (10MWT), timed "Up and Go" test (TUGT), and modified Ashworth Scale assess (MAS) of the lower limbs were performed at 0, 1, 4, and 12 weeks after treatment.

Results

At 1, 4, and 12 weeks after treatment, the L-FMA, stride length, speed, and TUGT significantly improved than 0 week in both groups. The L-FMA and peak of forefoot pressure, and MAS results in the experimental group were better than those in the control group at 4 and 12 weeks. The TUGT, speed, and stride length in experimental group was significantly shortened than that in control group at 1, 4, and 12 weeks.

Conclusion

Botulinum toxin type A injection can improve motor functions of the lower limb, gait, spasticity, forefoot pressure, and posture control of patients after stroke.

Conservative versus surgical treatment of foot drop in peroneal nerve entrapment: rationale and design of a prospective, multi-centre, randomized parallel-group controlled trial

BACKGROUND

High-quality evidence is lacking to support one treatment strategy over another in patients with foot drop due to peroneal nerve entrapment. This leads to strong variation in daily practice.

METHODS/DESIGN

The FOOTDROP (Follow-up and Outcome of Operative Treatment with Decompressive Release Of The Peroneal nerve) trial is a randomized, multi-centre study in which patients with peroneal nerve entrapment and persistent foot drop, despite initial conservative treatment, will be randomized 10 (± 4) weeks after onset between non-invasive treatment and surgical decompression. The primary endpoint is the difference in distance covered during the 6-min walk test between randomization and 9 months later. Time to recovery is the key secondary endpoint. Other secondary outcome measures encompass ankle dorsiflexion strength (MRC score and isometric dynamometry), gait assessment (10-m walk test, functional ambulation categories, Stanmore questionnaire), patient-reported outcome measures (EQ5D-5L), surgical complications, neurological deficits (sensory changes, motor scores for ankle eversion and hallux extension), health economic assessment (WPAI) and electrodiagnostic assessment.

DISCUSSION

The results of this randomized trial may elucidate the role of surgical decompression of the peroneal nerve and aid in clinical decision-making.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04695834. Registered on 4 January 2021.

Effect of ankle-foot orthoses on functional outcome measurements in individuals with stroke: a systematic review and meta-analysis

PURPOSE

To determine and compare the effect of ankle-foot orthosis (AFOs) types on functional outcome measurements in individuals with (sub)acute or chronic stroke impairments.

METHODS

PubMed, Web of Knowledge, Embase, Scopus, ProQuest, and Cochrane were searched from inception until September 2020. Methodological quality assessment of 30 studies was conducted based on the Downs and Black checklist. Functional indices were pooled according to their standardized mean difference (SMD) and 95% confidence intervals (CI) in a random-effect model. A narrative analysis was performed where data pooling was not feasible.

RESULTS

Overall pooled results indicated improvements in favor of AFOs versus without for the Berg Balance Scale (SMD: 0.54, CI: 0.19-0.88), timed-up and go test (SMD: -0.45, CI: -0.67 to -0.24), Functional Ambulatory Categories (SMD: 1.72, CI: 1.25-2.19), 6-Minute Walking Test (SMD: 0.91, CI: 0.53-1.28), Timed Up-Stairs (SMD: -0.35, CI: -0.64 to 0.05), and Motricity Index (SMD: 0.65, CI: 0.38-0.92). Heterogeneity was non-significant for all outcomes (I² < 50%, p > 0.05) except the Berg Balance Scale and Functional Ambulatory Categories. Additionally, there was not sufficient evidence to determine the effectiveness of specific orthotic designs over others.

CONCLUSIONS

An AFO can improve ambulatory function in stroke survivors. Future studies should explore the long-term effects of rehabilitation using AFOs and compare differences in orthotic designs.IMPLICATIONS FOR REHABILITATIONAn AFO can improve functional performance and ambulation in survivors of strokes.Wearing an AFO in rehabilitation care during the subacute phase post stroke may have beneficial effects on functional outcomes measured.There was no evidence as to the effectiveness of specific AFO designs over others.

The effects of anterior and posterior ankle-foot orthoses on sit-to-stand transfer performance in stroke patients

BACKGROUND

Nonarticulated and low-temperature thermoplastic ankle-foot orthoses (AFOs) have a semirigid design and are effective in improving the postural control mechanism (PCM) in individuals with poststroke hemiparesis. AFOs with an anterior leaf (AAFOs) are more often prescribed than are AFOs with a posterior leaf (PAFOs); however, the effects of AAFOs on the PCM during sit-to-stand transfer (STST) have not been explored.

RESEARCH QUESTIONS

Do AAFOs and PAFOs change the PCM differently during STST?

METHODS

A cross-sectional quasi-experimental design was adopted in this study. Fourteen individuals with poststroke hemiparesis (10 men and 4 women, aged between 38 and 71 years, stroke onset between 1 and 17 months) performed STST with shoes only, an AAFO with shoes, or a PAFO with shoes. Vertical ground reaction force (VGRF) and center-of-pressure (CoP) coordinates were collected using a pressure mat to calculate PCM parameters. A single-factor repeated measures analysis of variance was performed to answer the research question.

RESULTS

(1) The weight-bearing percentage of the paretic leg was significantly lower when the participants wore a PAFO (p = 0.018) than when they wore an AAFO (p = 0.019) during the first 5 and 5-10 s after rising. (2) A small rate of change of the VGRF increment (dF/dT) was detected when participants wore AFOs, particularly AAFO. (3) The maximum mediolateral displacement of the CoP when standing up was significantly different among the three conditions (p = 0.012).

SIGNIFICANCE

For patients with poststroke hemiparesis, AAFO and PAFOs change the PCM during STST performance. Only AAFO improved the PCM possibly because of the rigidity and clearance of the heel region, which provide somatic sensory feedback. Therefore, rehabilitation professionals should educate hemiplegic patients who use AAFOs or PAFOs to perform dynamic daily tasks slowly for their safety.

Recognizing Continuous Multiple Degrees of Freedom Foot Movements with Inertial Sensors

Recognition of continuous foot motions is important in robot-assisted lower limb rehabilitation, especially in prosthesis and exoskeleton design. For instance, perceiving foot motion is essential feedback for the robot controller. However, few studies have focused on perceiving multiple-degree of freedom (DOF) foot movements. This paper proposes a novel human-machine interaction (HMI) recognition wearable system for continuous multiple-DOF ankle-foot movements. The proposed system uses solely kinematic signals from inertial measurement units and multiclass support vector machines by creating error-correcting output codes. We conducted a study with multiple participants to validate the performance of the system using two strategies, a general model and a subject-specific model. The experimental results demonstrated satisfactory performance. The subject-specific approach achieved 98.45% ± 1.17% (mean ± SD) overall accuracy within a prediction time of 10.9 ms ± 1.7 ms, and the general approach achieved 85.3% ± 7.89% overall accuracy within a prediction time of 14.1 ms ± 4.5 ms. The results prove that the proposed system can more effectively recognize multiple continuous DOF foot movements than existing strategies. It can be applied to ankle-foot rehabilitation and fills the HMI high-level control demand for multiple-DOF wearable lower-limb robotics.

Multi-degrees-of-freedom soft robotic ankle-foot orthosis for gait assistance and variable ankle support

This paper presents the design, modeling, analysis, fabrication, and experimental characterization of the Soft Robotic Ankle-Foot Orthosis (SR-AFO), which is a wearable soft robot designed for ankle assistance, and a pilot human study of its use. Using two novel pneumatically-powered soft actuators, the SR-AFO is designed to assist the ankle in multiple degrees-of-freedom during standing and walking tasks. The flat fabric pneumatic artificial muscle (ff-PAM) contracts upon pressurization and assists ankle plantarflexion in the sagittal plane. The Multi-material Actuator for Variable Stiffness (MAVS) aids in supporting ankle inversion/eversion in the frontal plane. Analytical models of the ff-PAM and MAVS were created to understand how the changing of the design parameters affects tensile force generation and stiffness support, respectively. The models were validated by both finite element analysis and experimental characterization using a universal testing machine. A set of human experiments was performed with able-bodied participants to evaluate: 1) lateral ankle support during quiet standing, 2) lateral ankle support during walking over compliant surfaces, and 3) plantarflexion assistance during push-off in treadmill walking. Group results revealed increased lateral ankle stiffness during quiet standing with the MAVS active, reduced lateral ankle deflection while walking over compliant surfaces with the MAVS active, and reduced muscle effort in ankle platarflexors during 40-60% of the gait cycle with the dual ff-PAM active. The SR-AFO shows promising results in providing lateral ankle support and plantarflexion assistance with able-bodied participants, which suggests a potential to help restore the gait of impaired users in future trials.

Emergence of flexible technology in developing advanced systems for post-stroke rehabilitation: a comprehensive review

OBJECTIVE

Stroke is one of the most common neural disorders, which causes physical disabilities and motor impairments among its survivors. Several technologies have been developed for providing stroke rehabilitation and to assist the survivors in performing their daily life activities. Currently, the use of flexible technology (FT) for stroke rehabilitation systems is on a rise that allows the development of more compact and lightweight wearable systems, which stroke survivors can easily use for long-term activities.

APPROACH

For stroke applications, FT mainly includes the "flexible/stretchable electronics", "e-textile (electronic textile)" and "soft robotics". Thus, a thorough literature review has been performed to report the practical implementation of FT for post-stroke application.

MAIN RESULTS

In this review, the highlights of the advancement of FT in stroke rehabilitation systems are dealt with. Such systems mainly involve the "biosignal acquisition unit", "rehabilitation devices" and "assistive systems". In terms of biosignals acquisition, electroencephalography (EEG) and electromyography (EMG) are comprehensively described. For rehabilitation/assistive systems, the application of functional electrical stimulation (FES) and robotics units (exoskeleton, orthosis, etc.) have been explained.

SIGNIFICANCE

This is the first review article that compiles the different studies regarding flexible technology based post-stroke systems. Furthermore, the technological advantages, limitations, and possible future implications are also discussed to help improve and advance the flexible systems for the betterment of the stroke community.

A Clinical Practice Guideline for the Use of Ankle-Foot Orthoses and Functional Electrical Stimulation Post-Stroke

BACKGROUND

Level of ambulation following stroke is a long-term predictor of participation and disability. Decreased lower extremity motor control can impact ambulation and overall mobility. The purpose of this clinical practice guideline (CPG) is to provide evidence to guide clinical decision-making for the use of either ankle-foot orthosis (AFO) or functional electrical stimulation (FES) as an intervention to improve body function and structure, activity, and participation as defined by the International Classification of Functioning, Disability and Health (ICF) for individuals with poststroke hemiplegia with decreased lower extremity motor control.

METHODS

A review of literature published through November 2019 was performed across 7 databases for all studies involving stroke and AFO or FES. Data extracted included time post-stroke, participant characteristics, device types, outcomes assessed, and intervention parameters. Outcomes were examined upon initial application and after training. Recommendations were determined on the basis of the strength of the evidence and the potential benefits, harm, risks, or costs of providing AFO or FES.

RESULTS/DISCUSSION

One-hundred twenty-two meta-analyses, systematic reviews, randomized controlled trials, and cohort studies were included. Strong evidence exists that AFO and FES can each increase gait speed, mobility, and dynamic balance. Moderate evidence exists that AFO and FES increase quality of life, walking endurance, and muscle activation, and weak evidence exists for improving gait kinematics. AFO or FES should not be used to decrease plantarflexor spasticity. Studies that directly compare AFO and FES do not indicate overall superiority of one over the other. But evidence suggests that AFO may lead to more compensatory effects while FES may lead to more therapeutic effects. Due to the potential for gains at any phase post-stroke, the most appropriate device for an individual may change, and reassessments should be completed to ensure the device is meeting the individual's needs.

LIMITATIONS

This CPG cannot address the effects of one type of AFO over another for the majority of outcomes, as studies used a variety of AFO types and rarely differentiated effects. The recommendations also do not address the severity of hemiparesis, and most studies included participants with varied baseline ambulation ability.

SUMMARY

This CPG suggests that AFO and FES both lead to improvements post-stroke. Future studies should examine timing of provision, device types, intervention duration and delivery, longer term follow-up, responders versus nonresponders, and individuals with greater impairments.

DISCLAIMER

These recommendations are intended as a guide for clinicians to optimize rehabilitation outcomes for people with poststroke hemiplegia who have decreased lower extremity motor control that impacts ambulation and overall mobility.A Video Abstract is available as supplemental digital content from the authors (available at: http://links.lww.com/JNPT/A335).

Identifying Instruments to Assess Care Quality for Individuals With Custom Ankle Foot Orthoses: A Scoping Review

OBJECTIVES

We conducted 2 complementary scoping reviews to identify instruments that assess the experience and outcomes of custom ankle-foot orthosis (AFO) care in individuals with neurologic and traumatic conditions and to determine to what extent they might be psychometrically sound for AFO users. A stakeholder advisory committee considered to what extent the identified and psychometrically sound instruments might be feasible for use in developing quality measures for custom AFO users.

DATA SOURCES

Both scoping reviews were conducted using PubMed, the Cumulative Index to Nursing and Allied Health Literature, Embase, and Cochrane Systematic Reviews. The following were used for the first scoping review only: Cochrane Central Register of Controlled Trials and the Physiotherapy Evidence Database.

STUDY SELECTION

The initial scoping review yielded 79 articles with 82 instruments, 16 of which were used in 4 or more studies. The second scoping review yielded 57 articles reporting psychometric properties.

DATA EXTRACTION

Psychometric properties for populations who use AFOs were summarized for 15 of the 16 instruments. The advisory committee eliminated 2 insrtruments, noted overlap between 4 instruments in terms of the constructs measured, and suggested 6 potential contemporary substitutes.

DATA SYNTHESIS

Most instruments assessed activity (specifically mobility) and pertained to the National Quality Forum domain of "Health-Related Quality of Life." The 10-meter walk test, 6-minute walk test, Berg Balance Scale, Timed Up and Go, and Rivermead Mobility Index were reported to have adequate reliability and validity, and were considered feasible for administration in a clinical setting.

CONCLUSIONS

Complementary scoping reviews demonstrated that some instruments with reasonable psychometric properties are available that are feasible to use in developing quality measures for custom AFO care. However, experience of care instruments suitable for this population were not identified but are needed for a comprehensive evaluation of care quality for AFO users.

Effect of ankle-foot orthosis on functional mobility and dynamic balance of patients after stroke: Study protocol for a randomized controlled clinical trial

INTRODUCTION

Stroke is the principal cause of impairment in the motor function and gait of adults. One of the resources used in rehabilitation to optimize gait is a prescription of ankle-foot orthosis (AFO), and the most prescribed AFOs are Fixed AFO and Articulated AFO; however, it is not known which of these options is more effective for these individuals. The aim of this study is to evaluate the impact of different types of ankle-foot orthosis functional mobility and dynamic balance in stroke patients.

METHODS

Prospective randomized controlled clinical trial with 2 parallel groups will be conducted, and the aim is to recruit 50 patients with stroke diagnosis within 1 year, who indicated that they use both types of orthotics, who had a previous Rankin score less than or equal to 3, and who obtained AFO orthosis through the Hospital Clinics at the Botucatu Medical School (HCBMS) São Paulo, Brazil. After a specific evaluation by a physiotherapist, the patient will receive 1 of the AFO types via randomization. After 30 days, the patient will be reevaluated. The primary outcomes will be balance and mobility, which will be evaluated by the Time Up Go Test (TUG) and Tinetti's Scale of Mobility and Balance (TSMB). The secondary outcomes will be quality of life and the levels of anxiety and depression, which will be evaluated with the European (5D) Quality of Life Scale (Euroqol) and Hospital Anxiety and Depression Scale (HADS). Group allocation will be not concealed because the blinding of participants and of therapists that provide intervention is not possible, and all analyses will be based on an intention-to-treat principle. This study was approved by the Human Research Ethics Committee of the São Paulo State University UNESP, number 2.367.953. The results will be published in relevant journal.

DISCUSSION

The results of this study will contribute to clinical practice by identifying the type of AFO orthosis that is more suitable for this condition, helping to standardize prescription of these orthoses by professionals, and guiding future research studies on this subject, which is still incompletely defined in the literature.

TRIAL REGISTRATION

RBR-6SF2VV (March 5, 2018).

Effect of Kinesio Taping on the Walking Ability of Patients with Foot Drop after Stroke

Objective

The purpose of this study was to investigate the effect of kinesio taping on the walking ability in patients with foot drop after stroke.

Methods

Sixty patients were randomly divided into the experimental group (with kinesio taping) and the control group (without kinesio taping). The 10-Meter Walking Test (10MWT), Timed Up and Go Test (TUGT), stride length, stance phase, swing phase, and foot rotation of the involved side were measured with the German ZEBRIS gait running platform analysis system and were used to evaluate and compare the immediate effects of kinesio taping. All the measurements were made in duplicate for each patient.

Results

The demographic variables of patients in both groups were comparable before the treatment (p>0.05). After kinesio taping treatment, significant improvement was found in the 10MWT and the TUGT for patients in the experimental group (p<0.05). There were significant differences in the 10MWT and TUGT between the experimental and control groups after treatment (p<0.05). In terms of gait, we found significant improvement in stride length (p<0.001), stance phase (p<0.001), swing phase (p<0.001), and foot rotation (p<0.001) of the involved side in experimental group after treatment compared with those before treatment. Further, the functional outcomes and gait ability were significantly improved in the experimental group after treatment (p<0.05), compared to the control group.

Conclusion

Kinesio taping can immediately improve the walking function of patients with foot drop after stroke.

A novel hinged ankle foot orthosis for gait performance in chronic hemiplegic stroke survivors: a feasibility study

Stroke survivors with gait disturbances may use ankle foot orthoses (AFOs). However, most AFOs come in one-piece styles, which make it difficult for spasticity-affected stroke survivors to don. AFOs are also limited since they do not properly prevent ankle joint for foot drop by itself. Therefore, the present study developed a novel hinged AFO by adding a locking device to a hinged joint. We then tested its feasibility in 9 hemiplegic stroke survivors by investigating temporal-spatial gait parameters using the GAITRite in the following 3 conditions: no AFO, traditional AFO, and novel hinged AFO. There was no significant difference in spatiotemporal gait parameters among the different conditions. There were greater decreases in gait velocity, cadence, step length, and stride length in the novel hinged AFO group than in the no AFO and traditional AFO groups. This novel hinged AFO was developed to prevent foot drop. However, the AFO did not show significant differences in gait parameters because it consists of metal with extra weight and volume. Functionally, it prevented foot drop. It also improved convenience by its releasable design. Thus, further studies are needed to develop an AFO that improves gait and is convenient to use for hemiplegic stroke survivors.

A systematic review of physical rehabilitation interventions for stroke in low and lower-middle income countries

Purpose: Approximately 70% of strokes occur in low and middle income countries, yet the effectiveness of physical rehabilitation in these contexts remains undetermined. This systematic review identifies and summarises the current evidence supporting physical rehabilitation interventions post-stroke in low and lower-middle income countries.Methods: Five databases were comprehensively searched (April 2017) for randomised controlled trials, clinical controlled trials, and cohort studies testing rehabilitation interventions post-stroke in these countries. The Effective Public Health Practice Project Tool assessed quality of included studies.Results: Sixty-two studies (2115 participants) were included. Interventions addressed upper limb (n = 26), lower limb (n = 22), and other (n = 14) outcomes. Seven studies were rated as strong in quality, 16 moderate and 39 rated as weak. Overall, in addition to usual care, physical rehabilitation interventions improved outcomes for stroke survivors. Best evidence synthesis provides level I (b) evidence supporting constraint induced movement therapy and mirror therapy to improve upper limb functional outcomes. Level I (b) evidence supports multimodal interventions that include lower limb motor imagery to improve gait parameters. Level II (b) evidence supports sit-to-stand training to improve balance outcomes.Conclusions: Exercise-based and brain training interventions improved functional outcomes post-stroke in low and lower-middle income countries. Further high-quality studies including participation outcomes are required.Implications for RehabilitationLow-cost physical rehabilitation interventions requiring minimal resources can improve functional outcomes after stroke in low and lower-middle income countries.Exercise-based interventions can improve upper limb, lower limb, gait, and balance outcomes after stroke.Brain training paradigms such as mirror therapy and motor imagery, when included in therapy packages, can improve upper limb and gait outcomes.The proven efficacy for rehabilitation interventions in improving stroke outcomes in low and lower-middle income countries supports the need to strengthen the rehabilitation workforce in this context.

Effectiveness of robo-assisted lower limb rehabilitation for spastic patients: A systematic review

BACKGROUND

Though many rehabilitative treatments are available for treatment of spasticity, thus the effectiveness of different robo-rehabilitative devices needs to be evaluated through a systematic review.

OBJECTIVE

The objective of this study is to focuses on the efficacy of Robot assistive rehabilitation device for the removal of spasticity from the lower limb of Spastic patients.

DATA SOURCESSOURCES

PubMed, Web of Sciences, EMBASE (Excerpta Medical database), CDSR (Cochrane database of systematic reviews), Scopus, IEEE Xplore, Wiley online library, MEDLINE (OvidSP), Science Direct, Springer Link were from January 1980 to September 2017 DATA EXTRACTIONEXTRACTION: Seventy-one publications from eleven databases published were selected using keywords Ankle foot, spasticity, robotic rehabilitation, efficacy of robotics and Ankle foot rehabilitation. The review is narrowed down to twenty-six articles which were selected for they focused on effects of Robot assistive rehabilitation device quantitatively.

RESULT

A quantitative study from analyzing 26 studies comprising of 786 subjects is carried out. The major outcome of the effectiveness of the robot assistive therapy for the movement of ankle and functioning of gait is deduced. As the used protocols and treatment procedures vary, made comparative study complex or impracticable.

CONCLUSION

Robo-rehabilitation possesses an ability to provide unified therapy protocols with greater ease in comparison to conventional therapies. They continuously prove to be irreplaceable assistant devices when it comes to providing excellent treatment in terms of improvement from this study. Though many mechatronic devices are available but the devices for treatment of early stage rehabilitation of stroke patients is very limited.

[The application of kinesiotaping for the rehabilitation of the post-stroke patients]

This review of the scientific literature was designed to consider the prospects for the application of kinesiotaping for the rehabilitation of the post-stroke patients. The relevance of the work arises from the absence of a systemic analysis of the large number of investigations that have been carried out during the past two years. The objective of the present review article was to evaluate the influence of kinesiotaping on the health status of the post-stroke patients and the course of their rehabilitative treatment based on the results of analysis of the scientific reports published during the period from 2015 to 2017. The analysis has demonstrated that the method under consideration makes it possible to effectively reduce spasticity, increase the paretic limb power, improve the static and dynamic balance, and alleviate the pain syndrome by virtue of the ability to improve the articulation proprioception and to regulate the muscle tone. Such effects are known to promote the reduction of muscle tone asymmetry in the patients suffering from hemiparesis and articulation instability which in its turn improves the patients' gait and walking ability, hightens their living standards, and allows to tolerate enhanced physical exertion. Kinesiotaping actually improves the locomotor function in the post-stroke patients Taken together, the advantages of the approach in question give reason to recommend kinesiotaping for the wide application for the combined rehabilitative treatment of the post-stroke patients.