Principles of Ankle-Foot Orthosis Prescription in Ambulatory Bilateral Cerebral Palsy

Brittany, a patient at Shriners Hospital for Children—Chicago rides an adaptive bike with a recreation therapist. Shriners Hospital for Children, Chicago photo.


Maintenance of upright posture and gait mobility is frequently a goal in supporting children with cerebral palsy (CP). Ankle-foot orthoses (AFOs) can play an important role in normalizing gait function in this population. Properly designed orthotic interventions consider common ankle and foot deformities, range-of-motion limitations, and natural history of CP.

Successful AFO prescription often requires interaction with complementary interventions such as physical therapy, spasticity management, and/or orthopedic management. Recognizing the impact of plantar flexion contractures and the effects of footwear on AFO alignment is key to effective orthotic management of gait dysfunction in children with CP.

2020 Principles of AFO Prescription in Ambulatory Bilateral CP

Principles of Ankle-Foot Orthosis Prescription in Ambulatory Bilateral Cerebral Palsy, Wright E, DiBello SA. Phys Med Rehabil Clin N Am. 2020 Feb;31(1):69-89. doi: 10.1016/j.pmr.2019.09.007.

  Further reading

FACT SHEET Ankle-Foot Orthoses and Footwear for Children with Cerebral Palsy-Selecting Optimal Designs, Supported by the Practice Committee of APTA Pediatrics. Developed by expert contributors Elaine Owen, MBE, MSc, SRP, MCSP and Kristie Bjornson, PT, PhD, MS. Illustrations by Elaine Owen and Peter Bull Art Studio, UK. © Elaine Owen. Special thanks to Kathy David, PT, MS for her contributions to the previous version of this fact sheet. © 2020 by the APTA Academy of Pediatric Physical Therapy, American Physical Therapy Association, 1020 N Fairfax St, Suite 400, Alexandria, VA 22314,

“That’s frustrating”: Perceptions of ankle foot orthosis provision, use, and needs among people with cerebral palsy and caregivers, Zaino NL, Yamagami M, Gaebler-Spira DJ, Steele KM, Bjornson KF, Feldner HA. Prosthet Orthot Int. 2023 Apr 1;47(2):147-154. doi: 10.1097/PXR.0000000000000165.

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