Several positive influences of
orthoses on gait in children with
cerebral palsy have been documented, as well as some detrimental effects. Most importantly, push-off is decreased in
orthoses, compromising a physiological third ankle rocker. The aim of this study was to evaluate the effect of three types of
orthosis on gait in a homogeneous group of children. All
orthoses aimed at improving push-off and normalizing the pathological plantarflexion-knee extension couple. Thirty-seven children (22 females, 15 males) with
hemiplegia, aged 4 to 10 years (30 Gross Motor Function Classification System [GMFCS] Level I, six GMFCS Level II), walked barefoot and with
orthoses being either Orteams (
orthoses with the dorsal part containing 11 sleeves), posterior leafsprings (PLS), or Dual
Carbon Fibre Spring ankle
foot orthosis (AFOs; CFO:
carbon fibre at the dorsal part of the
orthosis). All
orthoses were expected to prevent plantarflexion and allow dorsiflexion, thus improving first, second, and third rocker. The
orthoses were compared through objective gait analysis, including 3D kinematics and kinetics. All
orthoses successfully improved the gait pattern and only small differences were noted between the configurations of the different
orthoses. The CFO, however, allowed a more physiological third ankle rocker compared with the Orteam/PLS. Although the PLS ensured the highest correction at the ankle around initial contact, the CFO created a significantly higher maximal hip flexion moment in stance. In general, the results of this study indicated a substantial functional flexibility of the CFO.