The effect of tuning ankle foot orthoses–footwear combination on the gait parameters of children with cerebral palsy

@article{Eddison2013TheEO,
  title={The effect of tuning ankle foot orthoses–footwear combination on the gait parameters of children with cerebral palsy},
  author={Nicola Eddison and Nachiappan Chockalingam},
  journal={Prosthetics and Orthotics International},
  year={2013},
  volume={37},
  pages={107 - 95}
}
Background: There are a wide variety of ankle foot orthoses used in clinical practice which are characterised by their design, the material used and the stiffness of that material. Changing any of these three components will alter the effect of the ankle foot orthosis on gait. Objectives: The purpose of this article is to provide an overview on the available research on ankle foot orthosis–footwear combination tuning on the gait characteristics of children with cerebral palsy through a… 
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TLDR
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References

SHOWING 1-10 OF 117 REFERENCES
Effects of tuning of ankle foot orthoses-footwear combination using wedges on stance phase knee hyperextension in children with cerebral palsy – Preliminary results
TLDR
The findings of this study clearly indicate the potential clinical utility of tuning using wedges to correct knee hyperextension during the stance phase in children with cerebral palsy, however, observations support the need for an adequately powered study to assess the long-term effects of tuning on gait parameters, activity level and quality of life.
Changes in joint kinematics in children with cerebral palsy while walking with and without a floor reaction ankle-foot orthosis.
TLDR
To improve the extension of the knees and ankle in the stance of the CP patients floor reaction ankle-foot orthosis was effective, compared to barefoot walking on children with cerebral palsy.
The effect of fixed ankle foot orthoses in children with cerebral palsy
TLDR
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.
Relative contribution of footwear to the efficacy of ankle-foot orthoses
TLDR
The appropriate comparative baseline for assessing the efficacy of an AFO is subjects walking with existing footwear and not barefoot.
Comparison of three ankle-foot orthosis configurations for children with spastic hemiplegia.
TLDR
The HAFO was themost effective in controlling knee hyperextension in stance, while PLS was the most effective in promoting knee extension in children with >10 degree knee flexion in stance.
A comparison of gait with solid, dynamic, and no ankle-foot orthoses in children with spastic cerebral palsy.
TLDR
Although both orthoses would be recommended for children with spastic CP and excessive ankle plantar flexion during stance, additional individual factors should be considered when selecting either orthosis.
Ankle-foot orthoses: effect on gait in children with cerebral palsy
TLDR
Evaluating the effectiveness of Ankle-Foot Orthoses (AFOs) on gait function in patients with spastic cerebral palsy for whom orthoses were indicated to control dynamic equines deformity found them to benefit from AFOs for ambulation.
Effect of dynamic orthoses on gait: a retrospective control study in children with hemiplegia
TLDR
The results of this study indicated a substantial functional flexibility of the CFO®, which allowed a more physiological third ankle rocker compared with the Orteam®/PLS, and created a significantly higher maximal hip flexion moment in stance.
The effects of fixed and articulated ankle-foot orthoses on gait patterns in subjects with cerebral palsy.
TLDR
AAFOs are appropriate for subjects with varying degrees of calf spasticity, as long as adequate passive range of motion is available, and can be applied primarily to children who do not have a preexisting tendency to crouch.
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