A physiological comparison of the short-leg walking cast and an ankle-foot orthosis walker following 6 weeks of immobilization

Iatrogenically induced weakness, stiffness, and functional impairment associated with classical methods of short-leg cast immobilization have long been recognized. This study compares the effects of "controlled" immobilization with an ankle-foot orthosis (AFO) and short-leg cast (SLC) immobilization for 6 weeks. A significant reduction in loss of range of motion, muscular strength, and muscular atrophy, ie, functional impairment, at the time of cessation of immobilization was noted when an AFO was used. The additional advantages of an AFO are the elimination of multiple cast changes including economic benefits, ease in the assessment of functional improvement during treatment, and convenient adjustment for swelling and atrophy.