‘What if it were like this?’ Perception of mothers of children with cerebral palsy about the ankle‐foot orthosis of their children: A qualitative study

Abstract Background: It has been reported the effects of a hinged ankle-foot orthosis on the gait ability of children with cerebral palsy. However, no studies investigated the effects of the dorsiflexion angle of the hinged ankle-foot orthosis on the spatiotemporal gait parameters of children with cerebral palsy. This study aimed to investigate the immediate effects of a 10° dorsiflexion inducing ankle-foot orthosis the spatiotemporal gait parameters of children with spastic diplegia compared to barefoot and a hinged ankle-foot orthosis.Methods: This study was cross-over design. 10 children with spastic diplegia were walked with barefoot, a hinged ankle-foot orthosis, and a 10° dorsiflexion inducing ankle-foot orthosis. GAITRite was used to collect the spatiotemporal gait parameters including gait velocity, cadence, step length, stride length, single leg support, and double leg support. Results: It showed that a 10° dorsiflexion inducing ankle-foot orthosis significantly improved the gait velocity, cadence, step length, stride length, single leg support, and double leg support than barefoot and a hinged ankle-foot orthosis (p<.05). Conclusion: The results of this study implied that a 10° dorsiflexion inducing ankle-foot orthosis could improve the gait ability of children with spastic diplegia more than barefoot or a hinged ankle-foot orthosis. High quality future studies will need to examine the effects of hinged ankle-foot orthosis on gait ability according to dorsiflexion angles.

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Multidimensional Effects of Solid and Hinged Ankle-Foot Orthosis in Children With Cerebral Palsy

Pediatric Physical Therapy ◽

10.1097/pep.0000000000000826 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Sivaporn Limpaninlachat ◽

Saipin Prasertsukdee ◽

Robert J. Palisano ◽

Joshua Burns ◽

Jaranit Kaewkungwal ◽

...

Keyword(s):

Cerebral Palsy ◽

Ankle Foot Orthosis ◽

Children With Cerebral Palsy ◽

Multidimensional Effects ◽

Foot Orthosis

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Quantitative Evaluation of the Effects of Ankle Foot Orthosis on Gait in Children with Cerebral Palsy Using the Gait Profile Score and Gait Variable Scores

Journal of Developmental and Physical Disabilities ◽

10.1007/s10882-016-9472-6 ◽

2016 ◽

Vol 28 (3) ◽

pp. 367-379 ◽

Cited By ~ 9

Author(s):

Manuela Galli ◽

Veronica Cimolin ◽

Chiara Rigoldi ◽

Giorgio Albertini

Keyword(s):

Cerebral Palsy ◽

Quantitative Evaluation ◽

Ankle Foot Orthosis ◽

Children With Cerebral Palsy ◽

Profile Score ◽

Foot Orthosis ◽

Gait Variable

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A wearable gait analysis protocol to support the choice of the appropriate ankle-foot orthosis: A comparative assessment in children with Cerebral Palsy

Clinical Biomechanics ◽

10.1016/j.clinbiomech.2019.08.009 ◽

2019 ◽

Vol 70 ◽

pp. 177-185 ◽

Cited By ~ 2

Author(s):

Bruno Giuseppe Contini ◽

Elena Bergamini ◽

Martina Alvini ◽

Eugenio Di Stanislao ◽

Giuseppe Di Rosa ◽

...

Keyword(s):

Cerebral Palsy ◽

Gait Analysis ◽

Comparative Assessment ◽

Ankle Foot Orthosis ◽

Children With Cerebral Palsy ◽

Foot Orthosis ◽

Analysis Protocol

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A series of case studies on the effect of a midfoot control ankle foot orthosis in the prevention of unresolved pressure areas in children with cerebral palsy

Prosthetics and Orthotics International ◽

10.1080/03093640108726609 ◽

2001 ◽

Vol 25 (3) ◽

pp. 246-250 ◽

Cited By ~ 4

Author(s):

M. Bill ◽

R. McIntosh ◽

P. Myers

Keyword(s):

Cerebral Palsy ◽

Case Studies ◽

Muscle Tone ◽

Evidence Base ◽

Triceps Surae ◽

Orthotic Devices ◽

Ankle Foot Orthosis ◽

Children With Cerebral Palsy ◽

Foot Position ◽

Foot Orthosis

This paper reports on a series of case studies where improvements were sought in muscle tone and gait in children with cerebral palsy. A Midfoot Control Ankle Foot Orthosis (AFO) was developed to control foot position in a cohort of patients with cerebral palsy (CP). The concept of controlling midfoot and hindfoot with an encapsulated internal Supra-Malleolar AFO that fitted into an external AFO was shown to be effective in ambulant children with CP. Some initial problems of compliance were noted and postulated to be due to difficulties associated with previous orthotic devices. Evidence from the case studies suggest that the developed Supra-Malleolar AFO orthoses enables children with CP to maintain mobility without skin tissue damage, delays the need for surgery and at the same time maintains the length of the Triceps Surae (Gastrocnemius and Soleus) complex. Plans for further research are discussed which will contribute to the evidence base for this particular orthotic device.

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Gastrocnemius operating length with ankle foot orthoses in cerebral palsy

Prosthetics and Orthotics International ◽

10.1177/0309364616665731 ◽

2016 ◽

Vol 41 (3) ◽

pp. 274-285 ◽

Cited By ~ 3

Author(s):

Hwan Choi ◽

Tishya Anne Leong Wren ◽

Katherine Muterspaugh Steele

Keyword(s):

Cerebral Palsy ◽

Classification System ◽

Daily Life ◽

System Level ◽

Foot Orthoses ◽

Functional Classification ◽

Ankle Foot Orthosis ◽

Ankle Foot Orthoses ◽

Children With Cerebral Palsy ◽

Foot Orthosis

Background:Many individuals with cerebral palsy wear ankle foot orthoses during daily life. Orthoses influence joint motion, but how they impact muscle remains unclear. In particular, the gastrocnemius is commonly stiff in cerebral palsy. Understanding whether orthoses stretch or shorten this muscle during daily life may inform orthosis design and rehabilitation.Objectives:This study investigated the impact of different ankle foot orthoses on gastrocnemius operating length during walking in children with cerebral palsy.Study design:Case series, within subject comparison of gastrocnemius operating length while walking barefoot and with two types of ankle foot orthoses.Methods:We performed gait analyses for 11 children with cerebral palsy. Each child was fit with two types of orthoses: a dynamic ankle foot orthosis (Cascade dynamic ankle foot orthosis) and an adjustable dynamic response ankle foot orthosis (Ultraflex ankle foot orthosis). Musculoskeletal modeling was used to quantify gastrocnemius musculotendon operating length and velocity with each orthosis.Results:Walking with ankle foot orthoses could stretch the gastrocnemius more than barefoot walking for some individuals; however, there was significant variability between participants and orthoses. At least one type of orthosis stretched the gastrocnemius during walking for 4/6 and 3/5 of the Gross Motor Functional Classification System Level I and III participants, respectively. AFOs also reduced peak gastrocnemius lengthening velocity compared to barefoot walking for some participants, with greater reductions among the Gross Motor Functional Classification System Level III participants. Changes in gastrocnemius operating length and lengthening velocity were related to changes in ankle and knee kinematics during gait.Conclusion:Ankle foot orthoses impact gastrocnemius operating length during walking and, with proper design, may assist with stretching tight muscles in daily life.Clinical relevanceDetermining whether ankle foot orthoses stretch tight muscles can inform future orthotic design and potentially provide a platform for integrating therapy into daily life. However, stretching tight muscles must be balanced with other goals of orthoses such as improving gait and preventing bone deformities.

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The effect of tuning ankle foot orthoses–footwear combination on the gait parameters of children with cerebral palsy

Prosthetics and Orthotics International ◽

10.1177/0309364612450706 ◽

2012 ◽

Vol 37 (2) ◽

pp. 95-107 ◽

Cited By ~ 30

Author(s):

Nicola Eddison ◽

Nachiappan Chockalingam

Keyword(s):

Cerebral Palsy ◽

Foot Orthoses ◽

Ankle Foot Orthosis ◽

Gait Parameters ◽

Ankle Foot Orthoses ◽

Children With Cerebral Palsy ◽

Within Subjects ◽

Kinetics Of ◽

Kinematics And Kinetics ◽

Foot Orthosis

Background:There are a wide variety of ankle foot orthoses used in clinical practice which are characterised by their design, the material used and the stiffness of that material. Changing any of these three components will alter the effect of the ankle foot orthosis on gait.Objectives:The purpose of this article is to provide an overview on the available research on ankle foot orthosis–footwear combination tuning on the gait characteristics of children with cerebral palsy through a structured review.Study Design:Literature review.Methods:A thorough search of previous studies published in English was conducted within all major databases using relevant phrases without any limits for the dates. These searches were then supplemented by tracking all key references from the appropriate articles identified including hand searching of published books where relevant.Results:To date, there are 947 papers in the literature pertaining to the study of ankle foot orthosis. Of these, 153 investigated the use of ankle foot orthosis for children with cerebral palsy. All the studies included in this review were of a within-subjects design and the evidence levels were generally low.Conclusions:The overall results suggested that ankle foot orthosis–footwear combination tuning has the potential to improve the kinematics and kinetics of gait in children with cerebral palsy. However, the review highlights a lack of well-designed and adequately powered studies.Clinical relevanceWhile the research described in this article indicates an improvement in the gait of children with cerebral palsy following tuning of their ankle foot orthosis–footwear combination, there is still a paucity of research with quantitative data on the effects of kinematics and kinetics of ankle foot orthosis–footwear combination tuning, comparing untuned ankle foot orthosis–footwear combinations with tuned ankle foot orthosis–footwear combination. Furthermore, current research does not identify the effect of tuning on energy efficiency.

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