Review of preorthotic biomechanical considerations

The application of an ankle-foot orthosis in poststroke hemiplegia can improve the mechanics of ambulation and functional gait. However, prior to the fitting of an orthotic, the clinician should perform a thorough assessment of the biomechanical elements contributing to mobility problems within the patient. Many of these problems such as joint contracture or weakness should be addressed through physical therapy interventions prior to orthotic prescription. This article reviews the common biomechanical elements that contribute to mobility and gait disability in patients with stroke with special attention to orthotic management.