The Efficacy of AFO Use in Ambulatory Children with Spastic Diplegia

Introduction Ankle foot orthoses (AFOs) are prescribed for ambulatory children with spastic diplegia to improve biomechanical alignment and functional capability. Orthotic prescription is often based upon clinical experiences, treatment paradigms (biomechanical vs neurodevelopmental), and the perceived desires of the child/family. Previous investigations have reported that AFO use in ambulatory children with spastic diplegia normalizes ankle kinematics/kinetics and gait parameters ; however, a recent comparison of three AFO configurations to shoes alone concluded that all configurations promoted abnormal ankle kinematics in comparison to shoes alone with no significant improvement in walking efficiency . The purpose of this study was to examine the efficacy of three commonly prescribed AFO configurations (solid (SAFO), hinged (HAFO), posterior leaf spring (PLS) during gait and energy expenditure (O2 consumption) in ambulatory children with spastic diplegia.