Biomechanical Outcomes Related with Gait in Children with Cerebral Palsy Using Ankle-Foot Orthotic - A Systematic Review

Gait in children with cerebral palsy (CP) is often affected by motor impairments which limit the patient's ability to walk. To improve gait and reduce walking limitations, children with CP need to use ankle foot orthoses. An orthosis is an externally applied device that is designed and fitted to the body to achieve one or more of the following goals: a) Control biomechanical alignment. b) Correct or accommodate deformity, and 3) Protect and support an injury. This systematic review aims to describe research evidence supporting the use of ankle-foot orthoses to improve gait biomechanical outcomes among individuals with CP. Literature search was pursued from PubMed database. Studies were included if (1) they evaluated an outcome measure related with gait using ankle-foot orthotic (AFO) in children (2) considered children with a diagnosis of CP and have a (3) GMFCS classification of I, II or III. Papers were excluded if they evaluated (1) other population besides CP, (2) the use of orthoses other than AFOs and (3) gait analysis procedure was not presented. All the included studies have analyzed spatiotemporal parameters, the step length (m), stride length (m) and cadence (steps/minute) were the most frequently reported. Our findings showed that several studies have investigated the effects of AFOs, all of which have reported positive influences on at least one gait parameter, as well as positive changes in joint kinematics and kinetic in children with CP.