title: Comparison of 2 Orthotic Approaches in Children With Cerebral Palsy.
abstract: OBJECTIVE
  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.
authors.affiliation: Children's Orthopaedic Center (Drs Wren and Rethlefsen, and Ms Mueske, Dennis, and Healy), Children's Hospital Los Angeles, Los Angeles, California; Department of Radiology (Dr Wren), Children's Hospital Los Angeles, Los Angeles, California; Department of Biomedical Engineering (Dr Wren), University of Southern California, Los Angeles, California; Orthopliance Group (Mr Dryden), North Hollywood, California; Division of Pediatric Rehabilitation Medicine (Ms Dennis and Healy, and Dr Rethlefsen), Children's Hospital Los Angeles, Los Angeles, California.
authors.forename: Tishya A L
authors.initials: TA
authors.lastname: Wren
authors.forename: James W
authors.initials: JW
authors.lastname: Dryden
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Mueske
authors.forename: Sandra W
authors.initials: SW
authors.lastname: Dennis
authors.forename: Bitte S
authors.initials: BS
authors.lastname: Healy
authors.forename: Susan A
authors.initials: SA
authors.lastname: Rethlefsen
mesh_terms: D000842:Ankle / Q000503:physiopathology; D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D005528:Foot / Q000503:physiopathology; D005684:Gait; D006801:Humans; D008297:Male; D009989:Orthotic Devices; D017060:Patient Satisfaction; D016138:Walking