The Gait Comparison Chart was used to document changes in the patient’s gait pattern due to the AFO. Patient has a significant improvement in forward progression with the AFO. Her walking speed has increased significantly, as she is able to take a longer step with the Right lower limb. A longer step with the Right limb also indicates improvement in balance. Her energy consumption is lower as she no longer demonstrates the deviation of Right Thigh Retraction and does not hesitate to lower the Right limb on the ground. Introduction of the AFO did not improve the movement symmetry between the limbs, nor did it change the shock absorption mechanism. Since the AFO restricted movement at the ankle and introduced new deviations, the total number of deviations were the same with the AFO.
From the available sagittal plane videos, it is difficult to determine the patient’s step width and hip adduction angle. Hence, these deviations were not marked. When walking without the AFO, she has a greater than normal toe-out angle. With the AFO, she moves her Right limb into external rotation following heel strike, which results in a similar toe-out angle. Her step length is more asymmetrical with the AFO, as she is taking longer steps with the Right limb. As a result, her step length with the AFO has declined. Her stance time on the Right limb has increased and that on the Left limb has decreased, which has resulted in a significant improvement in stance time symmetry.
Overall, the patient’s gait shows a moderate improvement with the AFO and the patient is recommended to continue with the AFO. Since the AFO is only able to address the function of forward progression, additional physical therapy to address balance and symmetry is also recommended.
The completed gait comparison chart for this patient is given below.