title: The Effect of Ankle-Foot Orthoses on Community-Based Walking in Cerebral Palsy: A Clinical Pilot Study.
abstract: OBJECTIVE
  To examine the effect of ankle-foot orthoses (AFO) on walking activity in children with cerebral palsy (CP).
  
  
  METHODS
  We used a randomized cross-over design with 11 children with bilateral CP, mean age 4.3 years. Subjects were randomized to current AFO-ON or AFO-OFF for 2 weeks and then crossed over. Walking activity (average total steps/day), intensity, and stride rate curves were collected via an ankle accelerometer. Group effects were examined with the Wilcoxon signed-rank test and within-subject effects examined for more than 1 standard deviation change.
  
  
  RESULTS
  No significant group difference was found in average total daily step count between treatment conditions (P = .48). For the AFO-ON condition, 2 subjects (18%) increased total steps/day; 4 (36%) increased walking time; 2 (18%) had more strides at a rate of more than 30 strides/min; and 2 (18%) reached higher peak intensity.
  
  
  CONCLUSIONS
  Clinically prescribed AFO/footwear did not consistently enhance walking activity levels or intensity. Larger studies are warranted.
authors.affiliation: Seattle Children's Research Institute (Drs Bjornson and Zhou and Ms Rashid), University of Washington, Seattle, Washington; Northwestern Prosthetics Research Laboratory and Rehabilitation Engineering Research Program and Physical Medicine and Rehabilitation Department (Dr Fatone), Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Orthocare Innovations (Dr Orendurff), Mountlake Terrace, Washington; Division of Developmental and Behavioral Pediatrics (Dr Stevenson), Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
authors.forename: Kristie
authors.initials: K
authors.lastname: Bjornson
authors.forename: Chuan
authors.initials: C
authors.lastname: Zhou
authors.forename: Stefania
authors.initials: S
authors.lastname: Fatone
authors.forename: Michael
authors.initials: M
authors.lastname: Orendurff
authors.forename: Richard
authors.initials: R
authors.lastname: Stevenson
authors.forename: Sariya
authors.initials: S
authors.lastname: Rashid
mesh_terms: D000842:Ankle; D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D005260:Female; D061826:Foot Orthoses; D006801:Humans; D008297:Male; D010865:Pilot Projects; D016138:Walking