AFO wear time affects activity level in children with CP

A research study comparing the body functions and structures, activity and participation levels, and environmental factors to AFO-wearing time in children with spastic cerebral palsy (CP) found that prolonged AFO-wearing time was negatively correlated with activity-participation level and parental satisfaction.

Dynamic ankle-foot orthosis, DAFO. Cascade DAFO

The O&P EDGE November 8, 2021

Eighty children with spastic CP (Gross Motor Function Classification System I–III; mean age 7.3 ± 3.9 years) were divided into two groups with equal ages and duration of AFO usage, which was provided as a part of routine clinical care. The groups were made up of participants whose AFO use was six to 12 hours per day (n = 40) and 12 to 24 hours per day (n = 40).

The outcomes measured were the calf muscle’s spasticity (modified Ashworth Scale (MAS)), passive ankle dorsiflexion angle (DA), 66-item Gross Motor Function Measurement, Pediatric Berg Balance Scale, and Pediatric Quality of Life Inventory (PedsQL). Parental satisfaction was measured with a visual analog scale.

The researchers found no significant differences for the Pediatric Berg Balance Scale, MAS, and DA between the groups. Significant differences for the PedsQL (76.99 vs. 57.63), daily living activities (65.30 vs. 35.92), fatigue (76.9 vs. 56.85), and satisfaction (8.08 vs. 5.21) were found between the groups. The six-to-12-hour group had superiority for each outcome. Wearing time was significantly correlated with PedsQL and satisfaction, but not with MAS or DA.

AFO-wearing time seemed to depend on the child’s activity and participation levels rather than body functions and structures, according to the study.

Source The O&P EDGE


Comparison of body structure, function, activity, and participation levels according to ankle foot orthosis wearing time in children with spastic cerebral palsy, Unes S, Coskun G, Kerem Gunel M. Prosthet Orthot Int. 2021 Dec 1;45(6):506-512. doi: 10.1097/PXR.0000000000000048.

  Further reading

Moderate effect of ankle foot orthosis versus ground reaction ankle foot orthosis on balance in children with diplegic cerebral palsy, Sanad DA. Prosthet Orthot Int. 2022 Feb 1;46(1):2-6. doi: 10.1097/PXR.0000000000000060.

Effects of Hinged versus Floor-Reaction Ankle-Foot Orthoses on Standing Stability and Sit-to-Stand Performance in Children with Spastic Diplegic Cerebral Palsy, Wang YL, Chi WC, Chen CL, Yang CH, Teng YL, Yeung KT. Int J Environ Res Public Health. 2022 Jan 4;19(1):542. doi: 10.3390/ijerph19010542. Full text, PDF

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