A comparison of gait with solid, dynamic, and no ankle-foot orthoses in children with spastic cerebral palsy.
OBJECTIVE
This study compared the effects of dynamic ankle-foot orthoses (DAFOs) with a plantar-flexion stop, polypropylene solid ankle-foot orthoses (AFOs), and no AFOs on the gait of children with cerebral palsy (CP). These orthoses were used to reduce the excessive ankle plantar flexion during the stance phase of gait.


METHODS
Ten children with spastic CP (6 with diplegia and 4 with hemiplegia) were tested after wearing no AFOs for an initial 2-week period, solid AFOs for 1 month, no AFOs for an additional 2 weeks, and DAFOs for 1 month. The effects of the two orthoses and no AFOs on lower-extremity muscle timing, joint motions, and temporal-distance characteristics were compared.


RESULTS
Both orthoses increased stride length, decreased cadence, and reduced excessive ankle plantar flexion when compared with no orthoses. No differences were found for the gait variables when comparing the two orthoses.


CONCLUSIONS
Based on the data, the authors believe that although both orthoses would be recommended for children with spastic CP and excessive ankle plantar flexion during stance, additional individual factors should be considered when selecting either orthosis.
Radtka
S A
SA
Graduate Program in Physical Therapy, University of California, San Francisco 94143, USA.
Skinner
S R
SR
Dixon
D M
DM
Johanson
M E
ME
D000704:Analysis of Variance; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D004867:Equipment Design; D005260:Female; D005528:Foot; D005684:Gait; D006801:Humans; D008297:Male; D009119:Muscle Contraction; D009128:Muscle Spasticity / Q000503:physiopathology / Q000534:rehabilitation; D009989:Orthotic Devices