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Comparison of three ankle–foot orthosis configurations for children with spastic hemiplegia

Published online by Cambridge University Press:  12 June 2001

Cathleen E Buckon
Affiliation:
Prosthetic and Orthotics Department, Shriners Hospitals For Children, Portland, OR, USA.
Susan Sienko Thomas
Affiliation:
Prosthetic and Orthotics Department, Shriners Hospitals For Children, Portland, OR, USA.
Sabrina Jakobson-Huston
Affiliation:
Prosthetic and Orthotics Department, Shriners Hospitals For Children, Portland, OR, USA.
Michael Moor
Affiliation:
Prosthetic and Orthotics Department, Shriners Hospitals For Children, Portland, OR, USA.
Michael Sussman
Affiliation:
Shriners Hospitals For Children, Portland, OR, USA.
Michael Aiona
Affiliation:
Shriners Hospitals For Children, Portland, OR, USA.
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Abstract

The purpose of this study was to examine the effectiveness of the hinged ankle–foot orthosis (HAFO), posterior leaf spring (PLS), and solid ankle–foot orthosis (SAFO), in preventing contracture, improving efficiency of gait, and enhancing performance of functional motor skills in 30 children (21 male, 9 female; mean age 9 years 4 months; age range 4 to 18 years,) with spastic hemiplegia. Following a 3-month baseline period of no ankle–foot orthosis (AFO) use, each AFO was worn for 3 months after which ankle range of motion, gait analysis, energy consumption, and functional motor skills were assessed. The HAFO and PLS increased passive ankle dorsiflexion and normalization of ankle rocker function during gait. Normalization of knee motion in stance was dependent upon the knee abnormality present and AFO configuration. The HAFO was the most effective in controlling knee hyperextension in stance, while PLS was the most effective in promoting knee extension in children with >10° knee flexion in stance. Energy efficiency was improved in 21 of the children, with 13 of these children demonstrating the greatest improvement in HAFO and PLS. Improvements in functional mobility were greatest in the HAFO and PLS.

Type
Original Articles
Copyright
© 2001 Mac Keith Press

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