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Multicenter Study
. 2014 Apr;32(4):531-6.
doi: 10.1002/jor.22567. Epub 2013 Dec 23.

Foot and ankle joint movements inside orthoses for children with spastic CP

Xue-Cheng Liu  1 , David Embrey, Channing Tassone, Frederick Klingbeil, Carlos Marquez-Barrientos, Brenna Brandsma, Roger Lyon, Jeffrey Schwab, Sergey Tarima, John Thometz
Affiliations
Multicenter Study

Foot and ankle joint movements inside orthoses for children with spastic CP

Xue-Cheng Liu et al. J Orthop Res. 2014 Apr.

Abstract

We compared the ankle joint and foot segment kinematics of pediatric cerebral palsy (CP) participants walking with and without orthoses. A six segment foot model (6SF) was used to track foot motion. Holes were cut in the study orthoses so that electromagnetic markers could be directly placed on the skin. The Hinged Ankle Foot Orthoses (HAFO) allowed a significant increase in ankle dorsiflexion as compared to the barefoot condition during gait, but significantly constrained sagittal forefoot motion and forefoot sagittal range of motion (ROM) (p < 0.01), which may be detrimental. The Solid Ankle Foot Orthoses (SAFO) constrained forefoot ROM as compared to barefoot gait (p < 0.01). The 6SF model did not confirm that the SAFO can control excessive plantarflexion for those with severe plantarflexor spasticity. The supramalleolar orthosis (SMO) significantly (p < 0.01) constrained forefoot ROM as compared to barefoot gait at the beginning and end of the stance phase, which could be detrimental. The SMO had no effects observed in the coronal plane.

Keywords: cerebral palsy; foot segment model; gait; orthoses.

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Figures

Figure 1
Figure 1
A set-up of the 6FS model measurements with and without orthoses: (A) 6 sensors placed on the anatomical landmarks. (B) Sensors placed on the anatomical landmarks through the windows on the orthoses.
Figure 2
Figure 2
The positioning device used to help ensure a consistent posture between the barefoot standing trials and the trials using the AFOs. An outline of the feet was also used to ensure a consistent foot position between barefoot and AFO trials.
Figure 3
Figure 3
Comparison of forefoot dorsiflexion and plantarflexion, with and without orthoses, for the (A) HAFO (B) SAFO and (C) SMO groups.
See this image and copyright information in PMC

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