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A Comparison of Gait With Solid, Dynamic, and No Ankle-Foot Orthoses in Children With Spastic Cerebral Palsy

SA Radtka, PhD, PT, is Associate Clinical Professor, Graduate Program in Physical Therapy, University of California, Box 0736, San Francisco, CA 94143 (USA).
SR Skinner, MD, is Chief of Staff, Shriners Hospital for Children, San Francisco, Calif.
DM Dixon, PT, is Staff Physical Therapist, Midtown Physical Therapy, Sacramento, Calif.
ME Johanson, PT, is Research Associate, Orthopaedic Biomechanics Laboratory, Shriners Hospital for Children.

Background and Purpose. This study compared the effects of dynamic ankle-foot orthoses (DAFOs) with a plantar-flexion stop, polypropylene solid ankle-foot orthoses (AFOs), and no AFOs on the gait of children with cerebral palsy (CP). These orthoses were used to reduce the excessive ankle plantar flexion during the stance phase of gait. Subjects and Methods. Ten children with spastic CP (6 with diplegia and 4 with hemiplegia) were tested after wearing no AFOs for an initial 2-week period, solid AFOs for 1 month, no AFOs for an additional 2 weeks, and DAFOs for 1 month. The effects of the two orthoses and no AFOs on lower-extremity muscle timing, joint motions, and temporal-distance characteristics were compared. Results. Both orthoses increased stride length, decreased cadence, and reduced excessive ankle plantar flexion when compared with no orthoses. No differences were found for the gait variables when comparing the two orthoses. Conclusion and Discussion. Based on the data, the authors believe that although both orthoses would be recommended for children with spastic CP and excessive ankle plantar flexion during stance, additional individual factors should be considered when selecting either orthosis.

Key Words: Cerebral palsy • Gait analysis • Orthosis

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