title: Influence of orthosis on the foot progression angle in children with spastic cerebral palsy.
abstract: We retrospectively assessed the effect of ankle-foot orthosis (AFO) on the foot progression angle (FPA) of 97 children with spastic cerebral palsy (CP) who had undergone comprehensive computer-based gait analysis both barefoot and with their orthosis, during the same session. The physical examination results and the gait study temporal and kinematic parameters comprise the study data. We focused on the peak FPA reached during stance and swing phases and at mid-stance and mid-swing, and also measured the transverse rotations of the pelvis, the femur and the tibia. AFOs improved gait, as reflected by improved temporal parameters, but they also increased internal rotation of the feet in diplegic CP children by 4.29 degrees for mid-stance, and by 3.72 degrees for mid-swing. The correlation between components of the rotational profile and FPA was significant for the diplegic group. AFOs did not produce any noteworthy differences between walking barefoot and walking with the brace in the hemiplegic group in what concerns FPA. Children with diplegic CP who use AFOs walk with increased internal FPAs in their orthoses. These findings might be explained by anatomical attributes as well as dynamic features during gait.
authors.affiliation: Department of Pediatric Orthopaedics, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: barrydanino@hotmail.com.
authors.forename: Barry
authors.initials: B
authors.lastname: Danino
authors.affiliation: The Gait and Motion Analysis Laboratory, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Snir
authors.initials: S
authors.lastname: Erel
authors.affiliation: The Gait and Motion Analysis Laboratory, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Meital
authors.initials: M
authors.lastname: Kfir
authors.affiliation: The Gait and Motion Analysis Laboratory, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Sam
authors.initials: S
authors.lastname: Khamis
authors.affiliation: The Gait and Motion Analysis Laboratory, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Reuven
authors.initials: R
authors.lastname: Batt
authors.affiliation: Department of Pediatric Orthopaedics, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Hemo
authors.affiliation: Department of Pediatric Orthopaedics, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Shlomo
authors.initials: S
authors.lastname: Wientroub
authors.affiliation: Department of Pediatric Orthopaedics, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center, and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Shlomo
authors.initials: S
authors.lastname: Hayek
mesh_terms: D000293:Adolescent; D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005528:Foot / Q000503:physiopathology*; D061826:Foot Orthoses; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: CP; Foot progression angle; Gait analysis; Orthosis