Bespoke versus off-the-shelf ankle-foot orthosis for people with stroke: randomized controlled trial

Sarah Tyson, Andy Vail, Nessa Angelet Thomas, Katherine Woodward-Nutt, Sarah Plant, Pippa Tyrrell

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OBJECTIVE: The aim of the study was to compare the effect of two designs of ankle-foot orthosis on people with stroke.

DESIGN: The study design was an assessor-blind, multicentre randomized controlled trial.

SETTING: The setting was community stroke services.

PARTICIPANTS: A total of 139 community-dwelling stroke survivors with limited mobility were recruited.

INTERVENTIONS: The two most commonly used types of ankle-foot orthosis (bespoke and off-the-shelf) were chosen.

MAIN MEASURES: The main measures of the study were as follows: short- (6 weeks) and long-term (12 weeks) effects on stroke survivors' satisfaction; adverse events; mobility (Walking Handicap Scale); fear of falling (Falls Efficacy Scale-International (FES-I)) and walking impairments (gait speed and step length using the 5-m walk test).

RESULTS: Long-term satisfaction was non-significantly higher in the off-the-shelf group: 72% versus 64%; OR (95% CI) = 0.64 (0.31 to 1.3); P = 0.21. No statistically significant differences were found between the orthoses except that the off-the-shelf group had less fear of falling at short-term follow-up than the bespoke group: mean difference (95% CI) = -4.6 (-7.6 to -1.6) points on the FES-I; P = 0.003.

CONCLUSION: No differences between off-the-shelf and bespoke ankle-foot orthoses were found except that participants in the off-the-shelf orthosis group had less fear of falling at short-term follow-up.

Original languageEnglish
Pages (from-to)367-376
Number of pages10
JournalClinical Rehabilitation
Issue number3
Early online date31 Aug 2017
Publication statusPublished - Mar 2018


  • Aged
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Foot Orthoses/statistics & numerical data
  • Gait Disorders, Neurologic/etiology
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Risk Assessment
  • Single-Blind Method
  • Stroke/complications
  • Stroke Rehabilitation/instrumentation
  • Treatment Outcome


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