The Effects of Foot Orthoses and Sensory Facilitation on Lower Limb Electromyography: A Scoping Review

Background: Different types of ankle-foot orthoses are commonly used following lower limb surgery in children with bilateral spastic cerebral palsy. After three-dimensional gait analysis 1 year postoperatively, many children are recommended continued use of ankle-foot orthoses. Objectives: Our aims were to quantify the impact of ankle-foot orthoses on gait 1 year postoperatively and evaluate predictors for clinically important improvement. Study design: Prospective cohort study. Methods: A total of 34 ambulating children with bilateral cerebral palsy, with mean age 11 years (range 6–17), comprising 12 girls and 22 boys, were measured with three-dimensional gait analysis preoperatively (barefoot) and 1 year postoperatively (barefoot and with ankle-foot orthoses). Outcome was evaluated using gait profile score, key kinematic, kinetic and temporal–spatial variables in paired sample comparisons. Logistic regression was used to evaluate predictors for clinically important improvement with orthoses (⩾1.6° change in gait profile score). Results: Walking barefoot 1 year postoperatively, major improvements were seen in gait profile score and key variables. With ankle-foot orthoses, there were significantly improved step length and velocity, additional moderate reduction/improvement in gait profile score and knee moments and decreased stance ankle dorsiflexion compared to barefoot. Children using ground reaction ankle-foot orthoses ( n = 14) decreased stance knee flexion from 13.9° walking barefoot to 8.2° with orthoses. High gait profile score and more gait dysfunction preoperatively were significant predictors of clinically important improvement walking with orthoses. Conclusion: The results indicate improved gait function walking with ankle-foot orthoses versus barefoot 1 year after lower limb surgery. Stronger impact of ankle-foot orthoses was found in children with more pronounced gait dysfunction preoperatively. Clinical relevance The 1-year postoperative three-dimensional gait analysis is a useful method to assess treatment outcome after lower limb surgery in children with bilateral cerebral palsy and could also guide clinicians whether further treatment with ankle-foot orthoses is indicated, using clinically important differences as thresholds to evaluate their impact on gait.

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Quantifying lower limb inter-joint coordination and coordination variability after four-month wearing arch support foot orthoses in children with flexible flat feet

Human Movement Science ◽

10.1016/j.humov.2020.102593 ◽

2020 ◽

Vol 70 ◽

pp. 102593 ◽

Cited By ~ 1

Author(s):

AmirAli Jafarnezhadgero ◽

Seyed Hamed Mousavi ◽

Morteza Madadi-Shad ◽

Juha M Hijmans

Keyword(s):

Lower Limb ◽

Foot Orthoses ◽

Joint Coordination ◽

Flat Feet ◽

Arch Support

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Ankle foot orthoses for young children with cerebral palsy: a scoping review

Disability and Rehabilitation ◽

10.1080/09638288.2019.1631394 ◽

2019 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Pegah Firouzeh ◽

Lyn K. Sonnenberg ◽

Christopher Morris ◽

Lesley Pritchard-Wiart

Keyword(s):

Cerebral Palsy ◽

Young Children ◽

Scoping Review ◽

Foot Orthoses ◽

Ankle Foot Orthoses ◽

Children With Cerebral Palsy

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Ankle–foot orthosis alignment affects running mechanics in individuals with lower limb injuries

Prosthetics and Orthotics International ◽

10.1177/0309364619826386 ◽

2019 ◽

Vol 43 (3) ◽

pp. 316-324

Author(s):

Kelly A Schmidtbauer ◽

E Russell Esposito ◽

Jason M Wilken

Keyword(s):

Lower Extremity ◽

Lower Limb ◽

Knee Extensor ◽

Design Parameters ◽

Foot Orthoses ◽

Lower Limb Injury ◽

Limb Injuries ◽

Peak Knee ◽

Ankle Foot Orthoses ◽

Running Mechanics

Background: Individuals with severe lower extremity injuries often require ankle–foot orthoses to return to normal activities. Ankle–foot orthoses alignment is a key consideration during the clinical fitting process and may be particularly important during dynamic activities such as running. Objective: To investigate how 3° changes in sagittal plane ankle–foot orthoses alignment affect running mechanics. Study design: Controlled laboratory study. Methods: Twelve participants with unilateral lower limb injury ran overground and lower extremity running mechanics were assessed. Participants wore their passive-dynamic ankle–foot orthoses in three alignments: clinically fit neutral, 3° plantarflexed from clinically fit neutral, and 3° dorsiflexed from clinically fit neutral. Results: The 3° changes in sagittal alignment significantly influenced ankle mechanics during running. The plantarflexed alignment significantly decreased the peak ankle plantarflexor moment, peak knee extensor moment, and peak ankle and knee power absorption and generation compared to more dorsiflexed alignments. Alignment also altered footstrike angle, with dorsiflexed alignments associated with a more dorsiflexed footstrike pattern and plantarflexed alignments toward a more plantarflexed footstrike pattern. However, alignment did not influence loading rate. Conclusion: Small changes in ankle–foot orthoses alignment significantly altered running mechanics, including footstrike angle, and knee extensor moments. Understanding how ankle–foot orthoses design parameters affect running mechanics may aid the development of evidence-based prescription guidelines and improve function for ankle–foot orthoses users who perform high-impact activities. Clinical relevance Understanding how ankle–foot orthoses alignment impacts biomechanics should be a consideration when fitting passive-dynamic devices for higher impact activities, such as running. Individual running styles, including footstrike patterns, may be affected by small changes in alignment.

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