What intervention is recommended to enhance walking endurance for patients with poststroke hemiplegia?

The recommendation to use an AFO (Ankle Foot Orthosis) or FES (Functional Electrical Stimulation) for enhancing walking endurance in patients with poststroke hemiplegia is grounded in their functional roles in supporting improved gait mechanics and overall mobility.

AFOs are designed to provide support to the foot and ankle, destabilizing the affected side and promoting proper alignment during gait. This is particularly important for individuals who may have weakness or spasticity that affects their ability to walk. By stabilizing the ankle and foot, an AFO can facilitate better weight-bearing and propulsion during the walking cycle, ultimately enhancing endurance.

On the other hand, FES involves the application of electrical stimulation to activate specific muscle groups during movement. This technology can stimulate the muscles responsible for dorsiflexion or propulsion, thereby promoting a more natural gait pattern. FES can also enhance muscle strength and coordination, which contributes to increased walking endurance over time.

The combination of AFOs and FES can significantly improve patients’ abilities to walk longer distances and with more confidence, thereby addressing both the mechanical and neuromuscular deficits typically seen in poststroke patients. This intervention is evidence-based and well-supported in literature regarding poststroke rehabilitation and walking endurance.