Ankle-foot orthoses (AFOs) are widely prescribed for stroke rehabilitation. We
investigated the potential of transcranial magnetic stimulation (TMS) at an early
stage, after stroke, to predict the need of using AFOs in stroke patients. We
recruited 35 patients who could walk with intermittent support of one person or
independently 3 months after onset of stroke. The patients included in the study
were classified into two groups: a TMS (+) group (n 10), in which motor-evoked
potential (MEP) in the affected tibialis anterior (TA) was present, and a TMS (-)
group (n 25), in which the MEP in the affected TA was absent. Three months
after the onset of stroke, we investigated whether patients were using AFOs or
not. We also checked the motor function of the affected lower extremity using the
Medical Research Council (MRC) scale. After 3 months of onset of stroke in the
TMS (+) group, 4 patients (40%) were using an AFO during ambulation. In the TMS
(-) group, 21 patients (84%) were using an AFO. The probability of using AFOs in
the 2 groups were significantly different. Additionally, 3 months after the onset
of stroke, the MRC scores of ankle dorsiflexor power, on the affected side, were
significantly higher in the TMS (+) group. Early TMS evaluation of the
corticospinal tract to the TA appears to be useful for predicting the need of
using AFOs in stroke patients during the recovery phase.