OBJECTIVE: To determine the effectiveness of an ankle foot orthosis (AFO) on mobility, walking and balance in people with stroke. DATA SOURCES: The following databases were searched from inception to November 2011; Cochrane Stroke, Movement Disorders and Injuries Groups, Medline, Embase, CINAHL, AMED, PsycINFO, PEDro. Previous reviews, reference lists and citation tracking of the selected articles were screened and the authors of selected trials contacted for any further unpublished data. STUDY SELECTION: Randomised controlled trials of AFOs in people with stroke which measured balance, walking impairments or mobility and reported in English were selected. Then the authors independently identified trials, extracted data, and assessed trial quality. DATA EXTRACTION: Trials with a low risk of selection, performance and attrition bias were selected for analysis. Information on the trial design, population recruited, intervention delivered, outcomes measured and the mean and standard deviation values for the treatment and control groups were extracted. DATA SYNTHESIS: Continuous outcomes were combined using weighted or standardised mean difference with 95%CI and fixed-effect model. 13 trials with 334 participants were selected. The effect of an AFO on walking activity (p = 0.00 to 0.0001), walking impairment (p = 0.02) and balance (weight distribution) (p = 0.003) was significant and beneficial. The effect on postural sway (p = 0.1) and timed mobility tests (p = 0.07 to 0.09) was non-significant and the effect on functional balance was mixed. The selected trials were all cross-over trials of the immediate effects; long term effects are unexplored. CONCLUSIONS: An AFO can improve walking and balance after stroke 26 but only the immediate effects have been examined. The effects and acceptability of long-term useage need to be evaluated.

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