A total of 20 studies was included in the review (n=446, range 6 to 115): 18 within-group studies and two between-group studies. Total quality scores ranged from 2 to 4, most studies (17) scored 3.
Kinematics and temporal-spatial gait characteristics: The use of solid ankle-foot orthoses (seven studies), hinged ankle-foot orthoses (four studies), dynamic ankle-foot orthoses (two studies) and tone-reducing ankle-foot orthoses (one study) improved the ankle position during heel strike. Solid ankle-foot orthoses (two studies), hinged ankle-foot orthoses (one study), dynamic ankle-foot orthoses (one study) and posterior leaf spring (two studies) led to a reduction in equinus during mid stance with an increased dorsiflexion at terminal stance observed for both hinged ankle-foot orthoses (two studies) and solid ankle-foot orthoses (one study). Negative effects from the use of ankle-foot orthoses were noted (two studies). Solid ankle-foot orthoses (eight studies), hinged ankle-foot orthoses (four studies), dynamic ankle-foot orthoses (two studies) and posterior leaf spring (one study) yielded increased stride and step length, gait velocity and single support time. Solid ankle-foot orthoses (three studies), hinged ankle-foot orthoses (one study), dynamic ankle-foot orthoses (one study) and posterior leaf spring (two studies) yielded decreased cadence, compared with no ankle-foot orthosis. No change in cadence was reported for solid ankle-foot orthoses (two studies), hinged ankle-foot orthoses (two studies) and posterior leaf spring (one study).
Lower Extremity Range of Motion: Significant increases in passive ankle dorsiflexion (with knees flexed and extended) were noted for solid ankle-foot orthoses, hinged ankle-foot orthoses and posterior leaf spring (two studies). Hinged ankle-foot orthoses and solid ankle-foot orthoses were associated with improved ankle dorsiflexion at initial contact (three studies), swing phase (two studies) and mid stance (one study), compared with the barefoot condition.
Energy expenditure: Decreased energy expenditure was observed with hinged ankle-foot orthoses (three studies), solid ankle-foot orthoses (two studies) and posterior leaf spring (one study).
Kinetic Analysis: Solid ankle-foot orthoses (three studies), hinged ankle-foot orthoses (two studies), dynamic ankle-foot orthoses (one study) and posterior leaf spring (one study) were associated with increased plantar-flexor moment.