• James V McLoughlin, Stephen R Lord, Christopher J Barr, Maria Crotty, and Daina L Sturnieks.
• Department of Rehabilitation, Aged and Extended Care, Flinders University, Adelaide, South Australia, Australia; University of New South Wales, Sydney, New South Wales, Australia. Electronic address: james.mcloughlin@flinders.edu.au.
• Arch Phys Med Rehabil. 2015 Feb 1;96(2):226-232.e1.

ObjectiveTo evaluate the effect of wearing a dorsiflexion assist orthosis (DAO) on walking distance, physiological cost, fatigue, and strength and balance measures after a modified 6-minute walk test (6MWT) in people with multiple sclerosis (MS).DesignRandomized crossover trial.SettingHospital Movement Laboratory.ParticipantsPeople with moderate MS and Expanded Disability Status Scale score of 3.7±0.7 (N=34; 26 women).InterventionsModified 6MWT with and without a DAO worn on the weaker leg.Main Outcome MeasuresDistance walked, perceived fatigue, and the physiological cost of walking were compared between walking conditions. Pre- and postwalk changes in knee extensor and ankle dorsiflexor isometric strength and standing postural sway with eyes open and closed were compared between walking conditions.ResultsThere were no differences in distance walked or perceived fatigue between the 2 walking conditions. However, there was a reduced physiological cost of walking (P<.05), a smaller reduction in knee extensor strength (P<.05), and a smaller increase in standing postural sway with eyes open (P<.01) after walking while wearing the DAO compared with walking without wearing the DAO.ConclusionsDespite not increasing walking distance or reducing perceived fatigue, the DAO reduced the physiological cost of walking and maintained knee strength and standing balance, which may have important implications for physical rehabilitation in people with MS. Further trials are required to determine whether the beneficial effects of wearing a DAO found here are maintained for longer periods.Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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