May 2022

Early KAFO Use Improves Functional Outcome in Stroke

  • Regaining gait ability is the most important goal of rehabilitation for activities of daily living (ADL) recovery in patients with stroke.
  • Knee ankle foot orthosis (KAFO) is sometimes used for gait training in stroke patients with severe motor paralysis.
  • Early wearing of the KAFO was associated with higher recovery of ADL.
  • Early wearing of the KAFO may accelerate ADL recovery in stroke patients who were prescribed a KAFO.

Objectives: KAFO is sometimes used for gait training in stroke patients. The impact of the time of wearing a KAFO on ADL recovery has not been clarified. This study aimed to examine the relationship between the days from onset to KAFO wearing and functional prognosis in patients after stroke.

Materials and methods: This retrospective, observational study was conducted with stroke patients who were prescribed a KAFO. Patients were divided into early and delayed groups according to the median days from onset to KAFO wearing. Baseline characteristics were evaluated at the initiation of KAFO wearing. The primary outcome was the Functional Independence Measure (FIM) gain, which was scored by the nurse at baseline and discharge.

Results: 112 participants (mean age 67.9 ± 14.0 years, 51.8% male) were included. The time period measure from day of onset to KAFO wearing for the early group was significantly shorter than the delayed group (35.8 ± 6.6 days vs. 73.5 ± 28.9 days). The early group had a higher FIM at discharge (84.9 ± 28.0% vs. 65.1 ± 29.0%, P < 0.001) and higher FIM gain (36.9 ± 19.8% vs. 26.8 ± 22.3, P = 0.013) than did the delayed group. Multiple regression analysis showed that the early group was associated with FIM gain (coefficient = 8.607, P = 0.032).

Conclusions: Early wearing of KAFO, irrespective of the difference in ADL at the time of KAFO wearing, may have a positive impact on the improvement of ADL in patients after stroke.

Source: Reprinted from Sato K, Inoue T, Maeda K, et al. Early Wearing of Knee-Ankle-Foot Orthosis Improves Functional Prognosis in Patients after Stroke. J Stroke Cerebrovasc Dis. 2022;31(3):106261. Reprinted with permission from Elsevier.

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