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Objective: To measure walking speed and energy cost in patients with prior stroke with and without a carbon composite ankle foot orthosis.

Design: Within-group comparisons of 2 walking condi-tions.

Participants: Convenience sample of 10 hemiparetic patients with a stroke at least 6 months earlier (average age 52 years) habituated to a carbon composite ankle foot orthosis.

Methods: Subjects walked on a treadmill at self-selected speed both with and without ankle foot orthosis for 5 minutes on each occasion. Energy expenditure was measured by breath-by-breath analysis and electrocardiography. Main outcome measures were walking speed, oxygen consumption, heart rate and energy cost per metre.

Results: Walking speed: without ankle foot orthosis 0.27 (SEM+ 0.03) m/s, with 0.34 (+ 0.06) m/s, difference 20%. Oxygen consumption: without ankle foot orthosis 8.6 (+ 0.4) ml/kg/min, with 8.8 (+ 0.5) ml/kg/min. Energy cost: without ankle foot orthosis 0.58 (+ 0.07) ml/kg/m, with 0.51 (+ 0.06) ml/kg/m, difference 12%.

Conclusion: Use of a carbon composite ankle foot orthosis in patients with stroke may increase speed and decrease energy cost during walking.