Gastrocnemius operating length with ankle foot orthoses in cerebral palsy

Abstract

Ankle foot orthoses impact gastrocnemius operating length during walking and, with proper design, may assist with stretching tight muscles in daily life. Clinical relevance Determining 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.

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

“…Our findings showed that the majority of studies introduced a costume made AFO build by an orthotist [1,8,13,19] in cooperation with a physical therapy, [1,8,13,19] although information about its composition and material was scarce [3,4,7,17].…”

“…Other limitation involved in some studies concerns the professional involved in AFO manufacturing [8,6,13,19] and gait analysis, [13] with only four studies mentioning the collaboration of a multidisciplinary team, like an orthotist, a physical therapist [8,6,13,19] and an engineer [13].…”

“…Although, a few studies [3,4,7,17] revealed that the custom made AFO was from prepreg carbon fibers. The majority of studies used a costume made AFO build by an orthotist [1,8,6,19] in cooperation with a physical therapy [8,6,13,19]. Further, two studies innovated on the intervention with AFO by adding a functional electrical stimulation (FES) device to the AFO.…”

“…The kinetic data was very restricted in the studies with only one third, [3,7,8,17] of the studies investigating this parameter, like the hip, knee and the ankle moment (Nm/kg) [1,8,17]. In the other hand kinematic analysis was often considered, like the knee flexion and extension angle (º) [3,8,17,19] and also the dorsiflexion ROM of the ankle [8,12,[19][20][21]. Nevertheless some studies also considered others outcomes, like functional outcomes related to daily activity and participation of the children, like Children's Assessment of Participation and Enjoyment (CAPE), [4,13,12] physical examination by physical therapist [4,16,17,12,21] and even outcomes related to the AFOs satisfaction [4,13,12] and others more specific measures related to the specific aim of the studies, summarized in "other parameters" at table II and table III. 3.7.…”

“…A case series study from Choi et al [19] investigated the impact of two different AFO on gastrocnemius operating length during walking in 11 children with CP. Gait analyses were performed and there was significant variability between participants and orthoses, however changes in gastrocnemius operating length were related to changes in ankle and knee kinematics during gait, with greater reductions among the GMFCS.…”