Bespoke versus off

The aim of the study was to compare the effect of two designs of ankle-foot orthosis on people with stroke. The study design was an assessor-blind, multicentre randomized controlled trial. The setting was community stroke services. A total of 139 community-dwelling stroke survivors with limited mobility were recruited. The two most commonly used types of ankle-foot orthosis (bespoke and off-the-shelf) were chosen. The main measures of the study were as follows: short- (6？weeks) and long-term (12？weeks) effects on stroke survivors’ satisfaction; adverse events; mobility (Walking Handicap Scale); fear of falling (Falls Efficacy Scale–International (FES-I)) and walking impairments (gait speed and step length using the 5-m walk test). Long-term satisfaction was non-significantly higher in the off-the-shelf group: 72% versus 64%; OR (95% CI)？=？0.64 (0.31 to 1.3); P？=？0.21. No statistically significant differences were found between the orthoses except that the off-the-shelf group had less fear of falling at short-term follow-up than the bespoke group: mean difference (95% CI)？=？？4.6 (？7.6 to ？1.6) points on the FES-I; P？=？0.003. No differences between off-the-shelf and bespoke ankle-foot orthoses were found except that participants in the off-the-shelf orthosis group had less fear of falling at short-term follow-up