Immediate Effects of the Dorsiflexion Angle of Hinged Ankle-foot Orthosis on the Spatiotemporal Gait Parameters of Children With Spastic Cerebral Palsy

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.

Combination taping technique versus ankle foot orthosis on improving gait parameters in spastic cerebral palsy: A controlled randomized study

Journal of Rehabilitation Medicine ◽

10.2340/jrm.v53.900 ◽

2021 ◽

Author(s):

Mohamed A. Abdel Ghafar ◽

Osama R Abdelraouf ◽

Amr A. Abdel-aziem ◽

Gihan Samir Mousa ◽

Ali O. Selim ◽

...

Keyword(s):

Cerebral Palsy ◽

Randomized Study ◽

Spastic Cerebral Palsy ◽

Control Group ◽

Spastic Diplegia ◽

Post Intervention ◽

Double Support ◽

Ankle Foot Orthosis ◽

Gait Parameters ◽

Background: One of the important goals in the treatment of spastic cerebral palsy is to maintain efficient and effective walking in order to be independent in activities and participate in society. Objective: To compare the efficacy of foot combination taping of kinesio tape and athletic tape vs ankle foot orthosis in correcting spatiotemporal gait parameters in children with spastic diplegia. Methods: Thirty-six children with spastic diplegia were randomly assigned into 3 groups; control, combination taping, and ankle foot orthosis groups. Children in the control group, in addition to those in both experimental groups, continued with conventional physical therapy, 1 h, 3 times per week for 4 weeks. Spatiotemporal gait parameters were assessed with the GAITRite system before and after the application of interventions. Results: Significant increases in walking velocity, step length, stride length, right single support duration, and left single support duration of the ankle foot orthosis and combination taping groups than pre-intervention values. [AQ9] Moreover, the post--intervention values of the double support duration of the ankle foot orthosis and combination taping groups were significantly lower than pre-intervention values. There were no significant differences between the post-intervention values of the ankle foot orthosis and combination taping groups for all parameters. Conclusion: The results demonstrated that combination taping is an effective alternative technique to ankle foot orthosis to improve spatiotemporal parameters in children with spastic diplegic in combination with conventional physiotherapy.

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 ◽

Within Subjects ◽

Kinetics Of ◽

Kinematics And Kinetics ◽

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.

Immediate Effect of Fabric Ankle-Foot Orthosis on Spatiotemporal Gait Parameters in Children With Spastic Cerebral Palsy

Physical Therapy Korea ◽

10.12674/ptk.2014.21.1.029 ◽

2014 ◽

Vol 21 (1) ◽

pp. 29-36 ◽

Cited By ~ 1

Author(s):

Yon-Ju Sim ◽

Dong-Ryul Lee ◽

Chung-Hwi Yi

Keyword(s):

Cerebral Palsy ◽

Spastic Cerebral Palsy ◽

Ankle Foot Orthosis ◽

Gait Parameters ◽

Pengaruh Penggunaan Ankle Foot Orthosis Dinamis Terhadap Kecepatan Jalan Pada Anak Penderita Cerebral Palsy

Jurnal Keterapian Fisik ◽

10.37341/jkf.v4i1.121 ◽

2019 ◽

Vol 4 (1) ◽

Author(s):

Cica Trimandasari M ◽

Sri Surini Pudjiastuti

Keyword(s):

Cerebral Palsy ◽

Walking Speed ◽

Wilcoxon Test ◽

Spastic Cerebral Palsy ◽

Motor Disorder ◽

Ankle Foot Orthosis ◽

Before And After ◽

Quasi Experimental ◽

Background: cerebral palsy is a non-progressive motor disorder that causes limited activity, paralysis, inability to control motion and is often accompanied by cognitive impairment or visual deficits.Children who experience cerebral palsy will definitely have limitations in the process of mobility. To help limitation of activity that occurs in children with cerebral palsy, ankle foot orthosis is used. Ankle foot orthosis is expected to help the patient in performing his activities at all times to give effect on the walking speed. In this research, actions performed by taking data before and after using dynamic ankle foot orthosis. Purpose of this research to determine the effect of the use of dynamic ankle foot orthosis on walking speed in children with cerebral palsy ". Methods: This type of research is quasi experimental pre and post test design. The subjects used were spastic cerebral palsy spherical patients in the Pediatric & Neurodevelopmental Therapy Center (PNTC) who had determined the inclusion and exclusion criteria. Number of subjects 15 people. Result: This research is based on data analysis result that wilcoxon test value got p = 0,001 (p <0,05). Conclusion: This result indicates that there is an effect of the use of ankle foot orthosis dynamic on road speed in children with cerebral palsy.

Effectiveness of an ankle–foot orthosis on walking in patients with stroke: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-95449-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yoo Jin Choo ◽

Min Cheol Chang

Keyword(s):

Stride Length ◽

Walking Speed ◽

Sagittal Plane ◽

Meta Analysis ◽

Step Length ◽

Stride Time ◽

Plane Angle ◽

Ankle Foot Orthosis ◽

Biomechanical Parameters ◽

AbstractWe conducted a meta-analysis to investigate the effectiveness of ankle–foot orthosis (AFO) use in improving gait biomechanical parameters such as walking speed, mobility, and kinematics in patients with stroke with gait disturbance. We searched the MEDLINE (Medical Literature Analysis and Retrieval System Online), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, Embase, and Scopus databases and retrieved studies published until June 2021. Experimental and prospective studies were included that evaluated biomechanics or kinematic parameters with or without AFO in patients with stroke. We analyzed gait biomechanical parameters, including walking speed, mobility, balance, and kinematic variables, in studies involving patients with and without AFO use. The criteria of the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate the methodological quality of the studies, and the level of evidence was evaluated using the Research Pyramid model. Funnel plot analysis and Egger’s test were performed to confirm publication bias. A total of 19 studies including 434 participants that reported on the immediate or short-term effectiveness of AFO use were included in the analysis. Significant improvements in walking speed (standardized mean difference [SMD], 0.50; 95% CI 0.34–0.66; P < 0.00001; I2, 0%), cadence (SMD, 0.42; 95% CI 0.22–0.62; P < 0.0001; I2, 0%), step length (SMD, 0.41; 95% CI 0.18–0.63; P = 0.0003; I2, 2%), stride length (SMD, 0.43; 95% CI 0.15–0.71; P = 0.003; I2, 7%), Timed up-and-go test (SMD, − 0.30; 95% CI − 0.54 to − 0.07; P = 0.01; I2, 0%), functional ambulation category (FAC) score (SMD, 1.61; 95% CI 1.19–2.02; P < 0.00001; I2, 0%), ankle sagittal plane angle at initial contact (SMD, 0.66; 95% CI 0.34–0.98; P < 0.0001; I2, 0%), and knee sagittal plane angle at toe-off (SMD, 0.39; 95% CI 0.04–0.73; P = 0.03; I2, 46%) were observed when the patients wore AFOs. Stride time, body sway, and hip sagittal plane angle at toe-off were not significantly improved (p = 0.74, p = 0.07, p = 0.07, respectively). Among these results, the FAC score showed the most significant improvement, and stride time showed the lowest improvement. AFO improves walking speed, cadence, step length, and stride length, particularly in patients with stroke. AFO is considered beneficial in enhancing gait stability and ambulatory ability.

Changes in joint kinematics in children with cerebral palsy while walking with and without a floor reaction ankle-foot orthosis

Clinics ◽

10.1590/s1807-59322007000100010 ◽

2007 ◽

Vol 62 (1) ◽

Cited By ~ 38

Author(s):

Paulo Roberto Garcia Lucareli ◽

Mário de Oliveira Lima ◽

Juliane Gomes de Almeida Lucarelli ◽

Fernanda Púpio Silva Lima

Keyword(s):

Cerebral Palsy ◽

Joint Kinematics ◽

Ankle Foot Orthosis ◽

Defining the Mechanical Properties of a Spring-hinged Ankle Foot Orthosis to Assess its Potential Use in Children With Spastic Cerebral Palsy

Journal of Applied Biomechanics ◽

10.1123/jab.2014-0046 ◽

2014 ◽

Vol 30 (6) ◽

pp. 728-731 ◽

Cited By ~ 9

Author(s):

Yvette L. Kerkum ◽

Merel-Anne Brehm ◽

Annemieke I. Buizer ◽

Josien C. van den Noort ◽

Jules G. Becher ◽

...

Keyword(s):

Mechanical Properties ◽

Cerebral Palsy ◽

Knee Flexion ◽

Spastic Cerebral Palsy ◽

Gait Performance ◽

Ankle Foot Orthosis ◽

The Moment ◽

Potential Use ◽

Foot Orthosis ◽

Walking Energy Cost

A rigid ventral shelf ankle foot orthosis (AFO) may improve gait in children with spastic cerebral palsy (SCP) whose gait is characterized by excessive knee flexion in stance. However, these AFOs can also impede ankle range of motion (ROM) and thereby inhibit push-off power. A more spring-like AFO can enhance push-off and may potentially reduce walking energy cost. The recent development of an adjustable spring-hinged AFO now allows adjustment of AFO stiffness, enabling tuning toward optimal gait performance. This study aims to quantify the mechanical properties of this spring-hinged AFO for each of its springs and settings. Using an AFO stiffness tester, two AFO hinges and their accompanying springs were measured. The springs showed a stiffness range of 0.01−1.82 N·m·deg−1. The moment-threshold increased with increasing stiffness (1.13–12.1 N·m), while ROM decreased (4.91–16.5°). Energy was returned by all springs (11.5–116.3 J). These results suggest that the two stiffest available springs should improve joint kinematics and enhance push-off in children with SCP walking with excessive knee flexion.