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A Randomized Controlled Evaluation of the Efficacy of an Ankle-Foot Cast on Walking Recovery Early After Stroke: SWIFT Cast Trial

Pomeroy, Valerie M.; Rowe, Philip; Clark, Allan; Walker, Andrew; Kerr, Andrew; Chandler, Elizabeth; Barber, Mark; Baron, Jean-Claude; Anderson, Lindsay; Dounavi, Myrto-Despoina; Earl, Leo; Gregory, Sheila; Havis, Claire; Horton, Simon; Jones, P. Simon; Kaliarntas, Konstantinos; Kennedy, Niamh; Lane, Kathleen; Legg, David; Marrapu, Siva T.; McColl, Emma; Moran, Hannah; Schutt, Hannah; Smith, Jessica; Ugboule, U. Chris


Valerie M. Pomeroy

Philip Rowe

Allan Clark

Andrew Walker

Andrew Kerr

Elizabeth Chandler

Mark Barber

Jean-Claude Baron

Lindsay Anderson

Myrto-Despoina Dounavi

Leo Earl

Sheila Gregory

Claire Havis

Simon Horton

P. Simon Jones

Niamh Kennedy

Kathleen Lane

David Legg

Siva T. Marrapu

Emma McColl

Hannah Moran

Hannah Schutt

Jessica Smith

U. Chris Ugboule


Background. Timely provision of an ankle-foot orthosis (AFO) orthotist customized for individuals early after stroke can be problematic. Objective. To evaluate the efficacy of a therapist-made AFO (SWIFT Cast) for walking recovery.
This was a randomized controlled, observer-blind trial. Participants (n = 105) were recruited 3 to 42 days poststroke.
All received conventional physical therapy (CPT) that included use of “off-the-shelf” and orthotist-made AFOs. People allocated to the experimental group also received a SWIFT Cast for up to 6 weeks. Measures were undertaken before randomization, 6 weeks thereafter (outcome), and at 6 months after stroke (follow-up). The primary measure was walking speed. Clinical efficacy evaluation used analysis of covariance. Results. Use of a SWIFT Cast during CPT sessions was
significantly higher (P < .001) for the SWIFT Cast (55%) than the CPT group (3%). The CPT group used an AFO in 26% of CPT sessions, compared with 11% for the SWIFT Cast group (P = .005). At outcome, walking speed was 0.42 (standard deviation [SD] = 0.37) m/s for the CPT group and 0.32 (SD = 0.34) m/s for the SWIFT Cast group. Follow-up walking speed was 0.53 (SD = 0.38) m/s for the CPT group and 0.43 (0.34) m/s for the SWIFT Cast group. Differences, after accounting for minimization factors, were insignificant at outcome (P = .345) and follow-up (P = .360). Conclusion and implications.
SWIFT Cast did not enhance the benefit of CPT, but the control group had greater use of another AFO. However, SWIFT Cast remains a clinical option because it is low cost and custom-made by therapists who can readily adapt it during the rehabilitation period.

Journal Article Type Article
Acceptance Date Dec 15, 2014
Online Publication Date Apr 30, 2015
Publication Date Jan 1, 2016
Deposit Date Jun 19, 2018
Publicly Available Date Jun 19, 2018
Journal Neurorehabilitation and Neural Repair
Print ISSN 1545-9683
Electronic ISSN 1552-6844
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 30
Issue 1
Pages 40-48
Keywords Rehabilitation; Neurology; Clinical Neurology;
Public URL
Contract Date Jun 19, 2018


A Randomized Controlled Evaluation Of The Efficacy Of An Ankle-Foot Cast On Walking Recovery Early After Stroke; SWIFT Cast Trial (673 Kb)

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Copyright Statement
This article is distributed under the terms of the Creative Commons Attribution 3.0 License ( which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (

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