A Comparison of the Effects of Solid, Articulated, and Posterior Leaf-spring Ankle-foot Orthoses and Shoes Alone on Gait and Energy Expenditure in Children with Spastic Diplegic Cerebral Palsy

Fourteen children with spastic diplegic cerebral palsy were evaluated wearing threedifferent ankle-foot orthoses and shoes alone. The ankle-foot orthoses included solid, articulated ankle, and posterior leaf-spring types. Evaluation measures included computerized gait analysis, Energy Efficiency Index data, and individual preference. Highly significant kinematic differences were found at the ankle with shoes alone approaching normative data and braces showing abnormal dorsiflexion. No significant differences, were found in velocity, cadence, stride length, or in the Energy Efficiency Index. Eight children preferred articulated braces, six chose posterior leaf-spring, and none chose the solid brace.