A Narrative Review of Alternate Gait Training Using Knee-ankle-foot Orthosis in Stroke Patients with Severe Hemiparesis

Stroke often leads to walking difficulties, making improved walking ability a top priority for stroke survivors. Alternate gait training (AGT) using a knee-ankle-foot orthosis (KAFO) may help patients with severe hemiplegia regain gait function. AGT involves walking with large hip movements while wearing a KAFO, which provides stability and allows for alternate stepping. This approach may facilitate afferent load and proprioceptive receptor inputs, promoting muscle activation in the paralyzed lower limbs. Case reports suggest that AGT can lead to remarkable recovery, even in patients who initially require full assistance to walk. The KAFO supports the inverted pendulum movement observed in normal walking.

• 1
  Alternate gait training (AGT) using a KAFO may benefit stroke patients with severe hemiparesis.
• 2
  AGT can lead to increased muscle activity in the affected lower limb compared to traditional 3-point gait training.
• 3
  Early prescription of KAFO combined with AGT may improve walking and stair climbing functions in post-stroke patients with severe hemiparesis.