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

Comparison of three ankle-foot orthosis configurations for children with spastic hemiplegia
Issue online:
02 Mar 2007
Accepted for publication 17th October 2000.
To cite this article: Cathleen E Buckon MS, Susan Sienko Thomas MA, Sabrina Jakobson-Huston CO, Michael Moor CPO, Michael Sussman MD, Michael Aiona MD (2001)
Comparison of three ankle-foot orthosis configurations for children with spastic hemiplegia
Developmental Medicine & Child Neurology 43 (6), 371Ò378.
doi:10.1111/j.1469-8749.2001.tb00224.x
Blackwell Synergy

Cathleen E Buckon MS** Correspondence to first author at Shriners Hospitals for Children, Portland Unit, 3101 SW Sam Jackson Park Road, Portland, OR 97201, USA. E-mail: CEB@SHCC.org11Research Associate Clinical Research Coordinator, Susan Sienko Thomas MA11Research Associate Clinical Research Coordinator, Sabrina Jakobson-HustonCO22Orthotist Manager, Prosthetic and Orthotics Department, Michael Moor CPO22Orthotist Manager, Prosthetic and Orthotics Department, Michael SussmanMD33Orthopedic Surgeon Assistant Chief of Staff, Shriners Hospitals For Children, Portland, OR, USA., Michael AionaMD33Orthopedic Surgeon Assistant Chief of Staff, Shriners Hospitals For Children, Portland, OR, USA.,

* Correspondence to first author at Shriners Hospitals for Children, Portland Unit, 3101 SW Sam Jackson Park Road, Portland, OR 97201, USA. E-mail: CEB@SHCC.org

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.

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