What is the recommended device for individuals with decreased lower extremity motor control aiming to improve gait speed after a stroke?

The best choice for enhancing gait speed in individuals with decreased lower extremity motor control following a stroke is the combination of an EFO (Electronic Functional Orthosis) or FES (Functional Electrical Stimulation).

These devices are specifically designed to improve motor control and facilitate muscle activation in the lower extremities. An EFO can provide assistance through electrical stimulation that promotes movement patterns conducive to walking, while FES directly stimulates the muscles to contract, helping to lift the foot during the swing phase of gait. This is particularly beneficial for those who have difficulty with dorsiflexion—the upward movement of the foot—an important component for clear and efficient walking.

Utilizing these devices targets the rehabilitation of neuromuscular function, encouraging neuroplastic changes in the brain following a stroke. This can enhance the overall effectiveness of rehabilitation strategies, making EFO/FES effective tools in building gait speed and improving independence in ambulation for stroke survivors.

While an AFO (Ankle-Foot Orthosis) provides support and can help with alignment, it may not actively promote muscle function or speed like the dynamic interventions that EFO or FES provide. Meanwhile, using a walker can offer support but does not directly address the underlying muscle control issues necessary for accelerating gait