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The effect of fixed ankle foot orthoses in children with cerebral palsy

Purpose. To identify the characteristics of children with cerebral palsy who benefited from tuning of their fixed ankle foot orthoses (AFOs) to create a screening tool. Method. A retrospective review was conducted using video records of 21 independently walking children with cerebral palsy who were referred to a Gait Laboratory for AFO tuning. All showed a ground reaction vector (GRV) in front of the knee (extending) when barefoot. The stance phase was digitised to obtain kinematic and kinetic parameters. Effectiveness of AFO tuning was judged by optimisation of the GRV at the knee and statistical and scatter plot analysis sought to discriminate between those who tuned and those who did not. Results. Analysis showed clear distinction between the two groups based on knee kinematics. Those who tuned showed flexion of no more than 20° in the first third of stance combined with movement towards extension in the second third of stance to a minimum of 10° flexion or less. Conclusions. This study has created a screening tool to identify children likely to benefit from AFO tuning based on kinematic data and which could be used in the community.