title: Changes in joint kinematics in children with cerebral palsy while walking with and without a floor reaction ankle-foot orthosis.
abstract: BACKGROUND
  The floor reaction ankle-foot orthosis is commonly prescribed in the attempt to decrease knee flexion during the stance phase in the cerebral palsy (CP) gait. Reported information about this type of orthosis is insufficient.
  
  
  OBJECTIVE
  The purpose of this study was to determine the effect of clinically prescribed floor reaction ankle-foot orthosis on kinematic parameters of the hip, knee and ankle in the stance phase of the gait cycle, compared to barefoot walking on children with cerebral palsy.
  
  
  METHODS
  A retrospective chart review of 2200 patients revealed that 71 patients (142 limbs) had a diagnosis of diplegia, with no contractures in hip, knee or ankle flexion. Their average age was 12.2 +/- 3.9. All of them were wearing clinically prescribed hinged floor reaction ankle-foot orthosis undergoing a three dimensional gait analysis. We divided the patients in three groups: Group I, with limited extension (maximum knee extension less than 15 masculine); Group II, with moderate limited extension (maximum knee extension between 15 masculine and 30 masculine) and Group III Crouch (maximum knee extension in stance more than 30 masculine).
  
  
  RESULTS
  Results indicate the parameters maximum knee extension and ankle dorsiflexion were significant in Group II e III; no change was observed in Group I. The maximum hip extension was not significant in all three groups.
  
  
  CONCLUSIONS
  when indicated to improve the extension of the knees and ankle in the stance of the CP patients floor reaction ankle-foot orthosis was effective.
authors.affiliation: Centro Universitário São Camilo, São Paulo, SP, Brazil. plucareli@hotmail.com
authors.forename: Paulo Roberto Garcia
authors.initials: PR
authors.lastname: Lucareli
authors.forename: Mário de Oliveira
authors.initials: Mde O
authors.lastname: Lima
authors.forename: Juliane Gomes de Almeida
authors.initials: JG
authors.lastname: Lucarelli
authors.forename: Fernanda Púpio Silva
authors.initials: FP
authors.lastname: Lima
mesh_terms: D000293:Adolescent; D000843:Ankle Joint / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D005684:Gait / Q000502:physiology*; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D009989:Orthotic Devices / Q000592:standards*; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies