This clinical practice guideline summaries the current available evidence on the use of AFOs and FES in people who have had a stroke. The authors summarise “ Strong evidence exists that AFO and FES can each increase gait speed, mobility, and dynamic balance. Moderate evidence exists that AFO and FES increase quality of life, walking endurance, and muscle activation, and weak evidence exists for improving gait kinematics. AFO or FES should not be used to decrease plantarflexor spasticity. Studies that directly compare AFO and FES do not indicate overall superiority of one over the other. But evidence suggests that AFO may lead to more compensatory effects while FES may lead to more therapeutic effects.  Due to the potential for gains at any phase post-stroke, the most appropriate device for an individual may change, and reassessments should be completed to ensure the device is meeting the individual’s needs.”

Reference: Johnston, Therese E. PT, MSPT, PhD, MBA*; Keller, Sarah PT, DPT, NCS; Denzer-Weiler, Caitlin PT, DPT, NCS; Brown, Lisa Brown, PT, DPT, NCS* A Clinical Practice Guideline for the Use of Ankle-Foot Orthoses and Functional Electrical Stimulation Post-Stroke, Journal of Neurologic Physical Therapy: April 2021 - Volume 45 - Issue 2 - p 112-196

doi: 10.1097/NPT.0000000000000347