The impact of an adjustable dynamic response ankle-foot orthosis on the gait of children with neurological and developmental conditions

Ms Stella Kravtsov1, Dr  Anna  Murphy1, Dr  Corey Joseph1

1Monash Health, Cheltenham, Australia

 

Aim:

Ankle –foot orthoses (AFO) are commonly prescribed for children with lower limb spasticity to improve ambulation.  Traditional, articulated AFOs restrict ankle plantarflexion range of motion (ROM) and allow dorsiflexion.  The Adjustable Dynamic Response (ADR) AFO is a new device on the market that controls both dorsiflexion and plantarflexion, however it’s efficacy over other AFO devices is unknown.

This study compared key gait characteristics in children with neurological and developmental conditions between two different orthoses; 1) an articulated AFO; and 2) an ADR AFO.

 

Method:

Fourteen children (5-14 years of age) participated in this study. Each participant was cast and fitted for their new ADR AFO at least three weeks prior to gait analysis testing. During gait analysis testing, each participant completed a minimum of 10 trials of 10m walks in each AFO. Three-dimensional lower limb kinematics and kinetics were captured using an eight camera VICON motion analysis system (100 Hz) and two in-ground Kistler force plates (1000 Hz). The primary outcome measures were peak knee flexion and extension, sagittal plane knee ROM, peak ankle dorsiflexion and plantarflexion, sagittal plane ankle ROM and peak ankle joint power. Spatiotemporal measures included walking velocity, cadence and stride length. This study used a within-subjects repeated measures design with paired t-tests to determine differences in outcome measures between the two AFO types.

 

Results:

Preliminary results analysed for the first eight children indicates no statistically significant differences in ankle and knee kinematics and kinetics during stance when comparing the ADR AFO to the articulated AFO. Data analysis for the additional 6 children is being finalised with final results to be provided at the Conference.

 

Conclusion:

The final results of this study will provide evidence to inform clinical practice on the appropriate prescription of ADR orthoses in the gait of children with neurological and developmental conditions.