Effects of rigid AFO design on the gait children with cerebral palsy
Research type
Research Study
Full title
The immediate response of gait to changes in posterior shell, rigid ankle-foot orthosis design and alignment in children with cerebral palsy.
IRAS ID
311000
Contact name
Sean Donald
Contact email
Sponsor organisation
University of Salford
Clinicaltrials.gov Identifier
n/a, n/a
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Plastic rigid ankle-foot orthoses (AFOs) are commonly prescribed to children with cerebral palsy (CP) to aid the management of gait impairments, which result damage to the central nervous system and atypical muscular and skeletal growth. However, current evidence on their efficacy is inconclusive and so a process known as biomechanical optimisation has been proposed to improve their performance. A prerequisite of this process is ensuring the AFO has sufficient stiffness to prevent ankle motion during walking, which is dictated by properties specified by the clinician during prescription. However, there is limited robust evidence for the relationship between AFO stiffness and gait characteristics in children with CP, with one recurrent issue being the use of AFOs with insufficient stiffness to limit ankle motion. Consequently, there is little justification for decision making during the AFO prescription. Furthermore, optimisation of AFO performance involves manipulating the position of the shank by changing the heel height of the AFO or footwear it is worn with, to dictate the position of the ankle, knee and hip. The aim is to create a more typical walking pattern which normalises the forces acting on the joints of the leg, restoring stability, a fundamental characteristic of walking. This process is known as tuning however research supporting its benefits is limited. Therefore, the aims of this study are to compare the walking characteristics of children with CP when wearing plastic rigid AFOs of different stiffness and before and after tuning. The motion and forces acting on the ankle, knee, hip, thigh and shank, time and distance parameters and stability during walking will all be assessed. Meanwhile, user acceptability as a proxy for compliance, will be evaluated through patient reported comfort scores.
REC name
London - Hampstead Research Ethics Committee
REC reference
23/LO/0520
Date of REC Opinion
21 Jun 2023
REC opinion
Favourable Opinion