AFO Prescription to Optimize Post-Stroke Function

NCT ID: NCT06692686

Last Updated: 2025-08-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-08

Study Completion Date

2027-10-31

Brief Summary

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The overall goal of this study is to attain the highest possible health-related quality of life for individuals with lower-limb impairment through a clinical trial examining three different modern carbon fiber ankle-foot orthosis (AFO) treatment options targeting the rehabilitation of individuals post-stroke. To achieve this goal, the investigators will:

1. Identify the factors that significantly contribute to an individual's highest potential quality of life when considering each of the three available AFO design options, and
2. Develop prediction models of clinical performance using biomechanical function linked to the three AFO designs.

Participants will be asked to:

* Wear each of the three modern AFO designs for one month, after receiving therapy training and
* Complete questionnaires and performance tests with each AFO.

In addition, the subset of individuals participating in goal 2) will also be asked to:

* Perform biomechanical analyses using high-speed cameras and force plates during different walking and balance tests with each AFO design.

Detailed Description

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Conditions

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Ankle Foot Orthosis (AFO) Stroke Patients Post-Stroke Hemiparesis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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PF-CS-MA

Participants will wear each of the three ankle-foot orthosis (AFO) treatment options over three separate four-week periods. In this arm, participants first use the pre-fabricated (PF) AFO, followed by the carbon strut (CS) AFO, and finally the multifunctional articulating (MA) AFO.

Group Type EXPERIMENTAL

Pre-fabricated (PF) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These pre-manufactured orthoses are customized to fit each patient. These devices can help to distribute weight evenly along the foot, but do not offer much opportunity for adjustment to a patient's specific needs. These AFOs achieve ankle motion through material deflection and lack a single point of articulation.

Carbon-strut (CS) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These AFO designs are built from a custom mold of the patient's affected limb for a more individualized fit. It includes a solid ankle design and achieves ankle motion through material deflection and lacks a single point of articulation.

Multifunctional articulating (MA) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These AFO designs are also built from a custom mold of the patient's affected limb, but these orthoses have a true articulation at the ankle to provide controlled ankle movement in a range determined appropriate by the orthotist through gait analysis.

PF-MA-CS

Participants will wear each of the three ankle-foot orthosis (AFO) treatment options over three separate four-week periods. In this arm, participants first use the pre-fabricated (PF) AFO, followed by the multifunctional articulating (MA) AFO, and finally the carbon strut (CS) AFO.

Group Type EXPERIMENTAL

Pre-fabricated (PF) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These pre-manufactured orthoses are customized to fit each patient. These devices can help to distribute weight evenly along the foot, but do not offer much opportunity for adjustment to a patient's specific needs. These AFOs achieve ankle motion through material deflection and lack a single point of articulation.

Carbon-strut (CS) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These AFO designs are built from a custom mold of the patient's affected limb for a more individualized fit. It includes a solid ankle design and achieves ankle motion through material deflection and lacks a single point of articulation.

Multifunctional articulating (MA) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These AFO designs are also built from a custom mold of the patient's affected limb, but these orthoses have a true articulation at the ankle to provide controlled ankle movement in a range determined appropriate by the orthotist through gait analysis.

CS-PF-MA

Participants will wear each of the three ankle-foot orthosis (AFO) treatment options over three separate four-week periods. In this arm, participants first use the carbon strut (CS) AFO, followed by the pre-fabricated (PF) AFO, and finally the multifunctional articulating (MA) AFO.

Group Type EXPERIMENTAL

Pre-fabricated (PF) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These pre-manufactured orthoses are customized to fit each patient. These devices can help to distribute weight evenly along the foot, but do not offer much opportunity for adjustment to a patient's specific needs. These AFOs achieve ankle motion through material deflection and lack a single point of articulation.

Carbon-strut (CS) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These AFO designs are built from a custom mold of the patient's affected limb for a more individualized fit. It includes a solid ankle design and achieves ankle motion through material deflection and lacks a single point of articulation.

Multifunctional articulating (MA) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These AFO designs are also built from a custom mold of the patient's affected limb, but these orthoses have a true articulation at the ankle to provide controlled ankle movement in a range determined appropriate by the orthotist through gait analysis.

CS-MA-PF

Participants will wear each of the three ankle-foot orthosis (AFO) treatment options over three separate four-week periods. In this arm, participants first use the carbon strut (CS) AFO, followed by the multifunctional articulating (MA) AFO, and finally the pre-fabricated (PF) AFO.

Group Type EXPERIMENTAL

Pre-fabricated (PF) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These pre-manufactured orthoses are customized to fit each patient. These devices can help to distribute weight evenly along the foot, but do not offer much opportunity for adjustment to a patient's specific needs. These AFOs achieve ankle motion through material deflection and lack a single point of articulation.

Carbon-strut (CS) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These AFO designs are built from a custom mold of the patient's affected limb for a more individualized fit. It includes a solid ankle design and achieves ankle motion through material deflection and lacks a single point of articulation.

Multifunctional articulating (MA) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These AFO designs are also built from a custom mold of the patient's affected limb, but these orthoses have a true articulation at the ankle to provide controlled ankle movement in a range determined appropriate by the orthotist through gait analysis.

MA-PF-CS

Participants will wear each of the three ankle-foot orthosis (AFO) treatment options over three separate four-week periods. In this arm, participants first use the multifunctional articulating (MA) AFO, followed by the pre-fabricated (PF) AFO, and finally the carbon strut (CS) AFO.

Group Type EXPERIMENTAL

Pre-fabricated (PF) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These pre-manufactured orthoses are customized to fit each patient. These devices can help to distribute weight evenly along the foot, but do not offer much opportunity for adjustment to a patient's specific needs. These AFOs achieve ankle motion through material deflection and lack a single point of articulation.

Carbon-strut (CS) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These AFO designs are built from a custom mold of the patient's affected limb for a more individualized fit. It includes a solid ankle design and achieves ankle motion through material deflection and lacks a single point of articulation.

Multifunctional articulating (MA) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These AFO designs are also built from a custom mold of the patient's affected limb, but these orthoses have a true articulation at the ankle to provide controlled ankle movement in a range determined appropriate by the orthotist through gait analysis.

MA-CS-PF

Participants will wear each of the three ankle-foot orthosis (AFO) treatment options over three separate four-week periods. In this arm, participants first use the multifunctional articulating (MA) AFO, followed by the carbon strut (CS) AFO, and finally the pre-fabricated (PF) AFO.

Group Type EXPERIMENTAL

Pre-fabricated (PF) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These pre-manufactured orthoses are customized to fit each patient. These devices can help to distribute weight evenly along the foot, but do not offer much opportunity for adjustment to a patient's specific needs. These AFOs achieve ankle motion through material deflection and lack a single point of articulation.

Carbon-strut (CS) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These AFO designs are built from a custom mold of the patient's affected limb for a more individualized fit. It includes a solid ankle design and achieves ankle motion through material deflection and lacks a single point of articulation.

Multifunctional articulating (MA) ankle-foot orthosis (AFO)

Intervention Type DEVICE

These AFO designs are also built from a custom mold of the patient's affected limb, but these orthoses have a true articulation at the ankle to provide controlled ankle movement in a range determined appropriate by the orthotist through gait analysis.

Interventions

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Pre-fabricated (PF) ankle-foot orthosis (AFO)

These pre-manufactured orthoses are customized to fit each patient. These devices can help to distribute weight evenly along the foot, but do not offer much opportunity for adjustment to a patient's specific needs. These AFOs achieve ankle motion through material deflection and lack a single point of articulation.

Intervention Type DEVICE

Carbon-strut (CS) ankle-foot orthosis (AFO)

These AFO designs are built from a custom mold of the patient's affected limb for a more individualized fit. It includes a solid ankle design and achieves ankle motion through material deflection and lacks a single point of articulation.

Intervention Type DEVICE

Multifunctional articulating (MA) ankle-foot orthosis (AFO)

These AFO designs are also built from a custom mold of the patient's affected limb, but these orthoses have a true articulation at the ankle to provide controlled ankle movement in a range determined appropriate by the orthotist through gait analysis.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* be a minimum of three months post-stroke
* be greater than 18 years of age
* have been prescribed either a semi-rigid or a custom-made articulating AFO
* wear their prescribed AFO for all primary mobility activity outside the house
* be able to walk at least 20 meters without manual assistance
* walk at least 10 meters per minute (12% of normal velocity) during a 6-meter self-selected velocity walking test.

Exclusion Criteria

* having a condition that could significantly limit ambulation, including severe osteoarthritis, rheumatoid arthritis, congestive heart failure, or pre-existing neurological disorder other than post-stroke
* having cognitive deficits that preclude their ability to provide consent for participation
* having an ankle plantar flexion contracture equal to or greater than 15 degrees plantar flexion with full knee extension
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University of South Carolina

OTHER

Sponsor Role collaborator

Rancho Los Amigos National Rehabilitation Center

OTHER

Sponsor Role collaborator

Hanger Clinic: Prosthetics & Orthotics

OTHER

Sponsor Role collaborator

Brooks Rehabilitation

OTHER

Sponsor Role collaborator

University of Texas at Austin

OTHER

Sponsor Role lead

Responsible Party

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Rick Neptune

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Rancho Research Institute

Downey, California, United States

Site Status RECRUITING

Brooks Rehabilitation

Jacksonville, Florida, United States

Site Status RECRUITING

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status RECRUITING

Hanger Clinic

Houston, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Richard R Neptune, PhD

Role: CONTACT

512-471-0848

Shelby L Walford, PhD

Role: CONTACT

Facility Contacts

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Jeffery Rankin, PhD

Role: primary

562-385-7177

Role: backup

Mark Bowden, PhD

Role: primary

352-318-2779

Steve Kautz, PhD

Role: primary

843-792-3867

Role: backup

Shane Wurdeman, PhD

Role: primary

402-290-8051

References

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Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA. 1995 Jan 4;273(1):59-65.

Reference Type BACKGROUND
PMID: 7996652 (View on PubMed)

Other Identifiers

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CDMRP-OP230030

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

STUDY00006128

Identifier Type: -

Identifier Source: org_study_id

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