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Comparison of 2 Orthotic Approaches in Children With Cerebral Palsy

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Purpose:

To compare dynamic ankle-foot orthoses (DAFOs) and adjustable dynamic response (ADR) ankle-foot orthoses (AFOs) in children with cerebral palsy.

Methods:

A total of 10 children with cerebral palsy (4-12 years; 6 at Gross Motor Function Classification System level I, 4 at Gross Motor Function Classification System level III) and crouch and/or equinus gait wore DAFOs and ADR-AFOs, each for 4 weeks, in randomized order. Laboratory-based gait analysis, walking activity monitor, and parent-reported questionnaire outcomes were compared among braces and barefoot conditions.

Results:

Children demonstrated better stride length (11-12 cm), hip extension (2°-4°), and swing-phase dorsiflexion (9°-17°) in both braces versus barefoot. Push-off power (0.3 W/kg) and knee extension (5°) were better in ADR-AFOs than in DAFOs. Parent satisfaction and walking activity (742 steps per day, 43 minutes per day) were higher for DAFOs.

Conclusions:

ADR-AFOs produce better knee extension and push-off power; DAFOs produce more normal ankle motion, greater parent satisfaction, and walking activity. Both braces provide improvements over barefoot.
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Keywords: ankle joint/physiopathology; articular; cerebral palsy/physiopathology; cerebral palsy/rehabilitation; child; foot; gait; hip joint/physiopathology; humans; knee joint/physiopathology; locomotor activity; muscle spasticity; orthotic devices; patient satisfaction; preschool; range of motion; walking

Document Type: Research Article

Publication date: September 1, 2015

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