A study that compared the effects of dynamic ankle-foot orthoses (DAFOs) and adjustable dynamic response (ADR) AFOs in children with cerebral palsy (CP) found that ADR AFOs produced better knee extension and push-off power while DAFOs produced more normal ankle motion, greater parent satisfaction, and walking activity. Both braces provided improvements over barefoot walking. The study was published online ahead of print on May 28 in the journal Pediatric Physical Therapy.
Ten children with CP and crouch and/or equinus gait participated in the study. The participants were four to 12 years old; six were at Gross Motor Function Classification System level I and four at Gross Motor Function Classification System level III. The children each wore DAFOs and ADR AFOs for four weeks, in randomized order. Laboratory-based gait analysis, walking activity monitor, and parent-reported questionnaire outcomes were compared among braces and barefoot conditions.
Participants demonstrated better stride length (11-12cm); hip extension (2-4 degrees); and swing-phase dorsiflexion (9-17 degrees) in both braces versus barefoot walking. Push-off power (0.3 W/kg) and knee extension (5 degrees) were better in ADR AFOs than in DAFOs. Parent satisfaction and walking activity (742 steps per day, 43 minutes per day) were higher for DAFOs.