Effect of dynamic orthoses on gait: a retrospective control study in children with hemiplegia

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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“…Owen, 73,109 Van Gestel et al 110 and Jagadamma et al 97 all describe the SVA used in their research.…”

Section: Discussionmentioning

confidence: 99%

“…Van Gestel et al 110 studied 36 children with hemiplegic CP. The study compared three different types of AFOs, and each permitted dorsiflexion.…”

Section: Discussionmentioning

confidence: 99%

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

Eddison

Chockalingam

2013

Prosthetics &Amp; Orthotics International

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“…31,32,35 Several other studies ensured homogeneity by describing knee and ankle posture either with 29,36,37,39 or without 38 reference to published gait classification systems. …”

Section: Participant Detailsmentioning

confidence: 99%

“…There is however some evidence suggesting that AFOs require individual adjustment, or tuning of the shankto-vertical angle in order to obtain optimal function. 53 While the concept of tuning is not new, it has only recently become more widely recognized which may explain why only five papers 9,36,39,54,55 reported tuning of the AFO interventions. Most studies in this review clearly reported the movements controlled by the AFO.…”

Section: Afo Detailsmentioning

confidence: 99%

A Systematic Review to Determine Best Practice Reporting Guidelines for AFO Interventions in Studies Involving Children with Cerebral Palsy

Ridgewell

Dobson

Bach

et al. 2010

Prosthetics &Amp; Orthotics International

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Studies which have examined the effects of ankle-foot orthoses (AFOs) on children with cerebral palsy (CP) often report insufficient detail about the participants, devices and testing protocols. The aim of this systematic review was to evaluate the level and quality of detail reported about these factors in order to generate best practice guidelines for reporting of future studies. A systematic search of the literature was conducted to identify studies which examined any outcome measure relating to AFO use in children with CP. A customized checklist was developed for data extraction and quality assessment. There was substantial variability in the level and quality of detail reported across the 41-paper yield. Many papers reported insufficient detail to allow synthesis of outcomes across studies. The findings of this review have been used to generate guidelines for best practice of reporting for AFO intervention studies. It is important to ensure homogeneity of gait pattern in a subject sample or to subdivide a sample to investigate the possibility that heterogeneity affected results. It is also important to describe the orthosis in sufficient detail that the device can be accurately replicated because differences in designs have been shown to affect outcomes. These guidelines will help researchers provide more systematic and detailed reports and thereby permit future reviewers to more accurately assess both the reporting and quality of orthotic interventions, and will facilitate synthesis of literature to enhance the evidence base.

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“…However, most studies on effectiveness of AFO have focused on gait [6][7][8][9], the effectiveness of AFO on STS movement has limited [10,11]. Compared with STS movement with barefoot, STS movement by using AFO was characterized by increasing ankle dorsiflexion.…”

Section: Introductionmentioning

confidence: 99%

A Preliminary Numerical Simulation Study of Developing Ankle Foot Orthosis to Support Sit-To-Stand Movement in Children with Cerebral Palsy

Nakagawa¹,

Yonetsu²,

Ito³

et al. 2017

ijacsa

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Abstract-The purpose of this study is to identify an effective method of support for the standing-up motion of children with cerebral palsy (CP). Experiments revealed remarkable differences in the shank and upper-body motions of children with CP compared with normally developed (ND) children. Shank tilt angles of CP children were smaller and their upper-body tilt angles were larger than those of ND children. The large upper-body tilt compensates for the smaller shank tilt but will cause back pain and/or deformation of the hip joint as they grow. It is therefore imperative to find a method of support to help CP children realize more natural motions (similar to those of ND children) to prevent these problems. The standing-up motion of ND children was adopted as the goal. Experiments identified a similarity in the angular variation between ND children's upper bodies and shanks; the standing-up motion of children with CP under that condition was then simulated using a two-dimensional four-link model of the human body. As a result of the numerical simulation, shank angles of CP children increased and their upper-body angles decreased from those measured during the experiments, which indicates that the proposed method of support is qualitatively effective at allowing CP children to realize a more natural standing-up motion.

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Effect of dynamic orthoses on gait: a retrospective control study in children with hemiplegia

Cited by 45 publications

References 22 publications

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

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

A Systematic Review to Determine Best Practice Reporting Guidelines for AFO Interventions in Studies Involving Children with Cerebral Palsy

A Preliminary Numerical Simulation Study of Developing Ankle Foot Orthosis to Support Sit-To-Stand Movement in Children with Cerebral Palsy

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