Research Output

A Randomized Controlled Evaluation of the Efficacy of an Ankle-Foot Cast on Walking Recovery Early After Stroke: SWIFT Cast Trial

  Background. Timely provision of an ankle-foot orthosis (AFO) orthotist customized for individuals early after stroke can be problematic. Objective. To evaluate the efficacy of a therapist-made AFO (SWIFT Cast) for walking recovery.
Methods.
This was a randomized controlled, observer-blind trial. Participants (n = 105) were recruited 3 to 42 days poststroke.
All received conventional physical therapy (CPT) that included use of “off-the-shelf” and orthotist-made AFOs. People allocated to the experimental group also received a SWIFT Cast for up to 6 weeks. Measures were undertaken before randomization, 6 weeks thereafter (outcome), and at 6 months after stroke (follow-up). The primary measure was walking speed. Clinical efficacy evaluation used analysis of covariance. Results. Use of a SWIFT Cast during CPT sessions was
significantly higher (P < .001) for the SWIFT Cast (55%) than the CPT group (3%). The CPT group used an AFO in 26% of CPT sessions, compared with 11% for the SWIFT Cast group (P = .005). At outcome, walking speed was 0.42 (standard deviation [SD] = 0.37) m/s for the CPT group and 0.32 (SD = 0.34) m/s for the SWIFT Cast group. Follow-up walking speed was 0.53 (SD = 0.38) m/s for the CPT group and 0.43 (0.34) m/s for the SWIFT Cast group. Differences, after accounting for minimization factors, were insignificant at outcome (P = .345) and follow-up (P = .360). Conclusion and implications.
SWIFT Cast did not enhance the benefit of CPT, but the control group had greater use of another AFO. However, SWIFT Cast remains a clinical option because it is low cost and custom-made by therapists who can readily adapt it during the rehabilitation period.

  • Type:

    Article

  • Date:

    30 April 2015

  • Publication Status:

    Published

  • Publisher

    SAGE Publications

  • DOI:

    10.1177/1545968315583724

  • Cross Ref:

    10.1177/1545968315583724

  • ISSN:

    1545-9683

  • Library of Congress:

    RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry

  • Dewey Decimal Classification:

    616.8 Nervous & mental disorders

  • Funders:

    Medical Research Council

Citation

Pomeroy, V. M., Rowe, P., Clark, A., Walker, A., Kerr, A., Chandler, E., …Ugboule, U. C. (2016). A Randomized Controlled Evaluation of the Efficacy of an Ankle-Foot Cast on Walking Recovery Early After Stroke: SWIFT Cast Trial. Neurorehabilitation and Neural Repair, 30(1), 40-48. doi:10.1177/1545968315583724

Authors

Keywords

Rehabilitation; Neurology; Clinical Neurology;

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