March 2015

More restrictive orthotic devices boost balance over time in children with CP

In the moment: O&P

By Jordana Bieze Foster

Balance improves over time in children with cerebral palsy (CP) who switch from a dorsiflexion-free orthotic device to a more restrictive one, according to research from Northwestern University’s Feinberg School of Medicine in Chicago.

Investigators analyzed five children with CP who regularly wore either supramalleolar orthoses or articulated ankle foot orthoses (AFOs) as they walked in each of two more-restrictive AFOs. The children had four weeks to accommodate to each new AFO.

The researchers found that switching devices had mixed effects with regard to step activity, walking endurance, patient satisfaction, and lifestyle participation—which may indicate that a longer transition time is warranted, according to Stefania Fatone, PhD, BPO (Hons), an associate professor of physical medicine and rehabilitation at the university, who presented the findings at the AAOP meeting in New Orleans.

But restricted motion was associated with improved balance over time in all patients, regardless of the specific device worn. This may mean that the improved stability provided by the orthotic devices facilitated strengthening of the more proximal muscles, although the study did not measure strength, Fatone said.


Fatone S. Effect of two orthotic approaches on activity level, balance, and satisfaction in children with cerebral palsy. Presented at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Sympo­- sium, New Orleans, February 2015.

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