In this study, presented by Susan Ann Rethlefsen, PT, DPT, Children’s Hospital Los Angeles, researchers compared two styles of ankle-foot orthoses — AFOs — dynamic (DAFO) and adjustable dynamic response (ADR), used for children with cerebral palsy who display crouch and/or equinus gait. Ten children were fit with both style AFOs in a randomized order for 4 weeks. During this time, the children wore a Stepwatch activity monitor.
Although both orthoses restricted plantarflexion in stance and swing phases vs barefoot, plantarflexion was significantly more limited in the DAFOs. Knee extension in stance was reported better in the ADR vs. the DAFO. Push-off power, while significantly reduced in both AFOs, was significantly higher in the ADR orthosis compared with the DAFO. Neither orthotic wear nor the type of orthosis affected gait asymmetry or standing balance.
In addition to kinematic and kinetic measurements, researchers made qualitative measurements of quality of life and preference. Subjective preference of patient satisfaction and activity favored the DAFO designs, which patients said were more cosmetic, lighter, lower in profile and easier to fit into shoes.
For more information, visit the Association for Children’s Prosthetic-Orthotic Clinics website at www.acpoc.org, call (847) 698-1637 or email acpoc@aaos.org.
Disclosure: Rethlefsen had no relevant financial disclosures.
