Hello. I believe this is the question you are mentioning: You note a 57-year-old male with right hemiparesis after a stroke demonstrates excessive right ankle dorsiflexion with knee flexion during static stance. During gait, the patient exhibits decreased foot clearance during swing phase and increased knee flexion during stance. Examination findings of the right lower extremity include: 4/5 knee extensor strength, 3/5 ankle dorsiflexor and plantarflexor strength, ankle range of motion grossly within functional limits, and grade 1 ankle plantarflexor spasticity. Which orthosis would be best for this patient?
The minimal spasticity gets rid of the rigid AFO option. The decreased foot clearance necessitates the DF assist (and because of the minimal spasticity we do not have to worry about using an assist) and the increased knee flexion/knee buckling in stance necessitates the DF stop or GRAFO. This leaves us with only 1 option that has both. The PF stop would be better if there was hyperextension in stance or increased PF spasticity. Spasticity that gets to 2 and higher starts to affect whether we can use assist with our AFOs or needing stops with the AFO. Hope this helps