AFO and FES Poststroke: Impact on Gait and Function
Presented by Therese E. Johnston and Lisa E. Brown
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Nonfinancial: Therese E. Johnston is a coauthor on the Clinical Practice Guideline (CPG) on ankle-foot orthosis (AFO) and functional electrical stimulation (FES) poststroke. She has presented material related to the CPG at multiple conferences.
Financial: Lisa E. Brown receives compensation from MedBridge for this course. She also received an honorarium from the Academy of Geriatric PT and Academy of Neurologic Physical Therapy.
Nonfinancial: Lisa E. Brown is a coauthor on the Clinical Practice Guideline (CPG) on ankle-foot orthosis (AFO) and functional electrical stimulation (FES) poststroke. She has presented material related to the CPG at multiple conferences.
The application of ankle-foot orthoses (AFO) and functional electrical stimulation (FES) to address the activity limitations and participation restrictions of individuals with neurologic conditions is common practice. The Clinical Practice Guideline for the Use of Ankle-Foot Orthosis and Functional Electrical Stimulation Post-Stroke provides evidence to guide physical therapists in the shared decision-making process. This course will introduce a patient-centered decision-making framework and demonstrate application through clinical case examples. Each case will present a patient-specific participation and activity limitation common to individuals with neurologic conditions. The potential device effects will be discussed, and a comparison of various FES and AFO types and their potential impact will be illustrated to determine the most appropriate device types. Clinical decision-making considerations will be highlighted to emphasize the need for a patient-centered approach to best meet the needs of the individual. Evidence from the CPG will be highlighted in each case and integrated throughout the presentation to further guide decision-making.
Learning Objectives
- Analyze the available evidence and clinical practice guideline recommendations to support the use of AFO and FES in individuals poststroke
- Determine device effects on gait and function
- Apply a shared clinical decision-making framework
- Integrate the available evidence for the use of AFO and FES, knowledge of gait subtasks, and results of a patient examination into the shared clinical decision-making for a patient/client case
Meet your instructors
Therese E. Johnston
Therese E. Johnston is a professor of physical therapy at Arcadia University in Glenside, Pennsylvania. Her neurological research focuses on interventions for individuals with spinal cord injury, with a special emphasis on functional electrical stimulation and cardiovascular and bone health. She has authored over sixty…
Lisa E. Brown
Lisa E. Brown is an associate clinical professor at Boston University and a highly experienced and dedicated physical therapist specializing in neurological conditions. Dr. Brown is a co-lead author on the Clinical Practice Guideline on the Use of Ankle-Foot Orthoses and Functional Electrical Stimulation Post-Stroke and has…
Chapters & learning objectives
1. Evidence Review for the Use of AFO and FES in Individuals Poststroke
This chapter will provide an overview of the available evidence, including the clinical practice guideline, for the use of AFO and FES poststroke. The critical elements of the eight CPG action statements will be highlighted.
2. Device Effects and Decision-Making Framework
This chapter will define the device effects and review the decision-making framework that will be used in the subsequent case examples.
3. Case 1: Gait Speed, Gait Subtasks, and Device Selection
This chapter will apply the evidence to support the use of AFO and FES to improve gait speed. The case example will apply the device definitions and subtasks of gait within the decision-making framework.
4. Case 2: Dynamic Balance, Gait Subtasks, and Device Selection
This chapter will apply the evidence to support the use of AFO and FES to improve dynamic balance. The case example will apply the device definitions and subtasks of gait within the decision-making framework.
5. Application Considerations for Device Effects
This chapter will apply the evidence related to device effects and potential impact on mobility, participation in rehabilitation, and impact on discharge destination.
