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The impacts of hinged and solid ankle-foot orthoses on standing and walking in children with spastic diplegia
Hamid Dalvand1, Leila Dehghan1, Awat Feizi2
1Department of Occupational Therapy, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran.
Insights
Hinged ankle-foot orthoses (AFOs) significantly improved gross motor function in children with spastic diplegia more than solid AFOs or no orthoses. This study highlights hinged AFOs as a beneficial intervention for enhancing mobility.
Area of Science:
- Pediatric Rehabilitation
- Orthotics and Prosthetics
- Neuromuscular Disorders
Background:
- Spastic diplegia is a common form of cerebral palsy affecting motor control.
- Ankle-foot orthoses (AFOs) are frequently used to support standing and walking in affected children.
- Understanding the comparative efficacy of different AFO types is crucial for optimizing treatment.
Purpose of the Study:
- To evaluate the impact of hinged versus solid ankle-foot orthoses (AFOs) on the standing and walking abilities of children with spastic diplegia.
- To compare the effectiveness of hinged AFOs, solid AFOs, and occupational therapy alone in improving gross motor function.
Main Methods:
- A quasi-experimental study involving 30 children (aged 4-6 years) with spastic diplegia, matched for age, IQ, and Gross Motor Function Classification System (GMFCS) level.
- Participants were randomly assigned to three groups: hinged AFOs plus occupational therapy (OT), solid AFOs plus OT, or OT alone, for three months.
- Gross motor function was assessed using the Gross Motor Function Measure (GMFM) before and after the intervention period.
Main Results:
- All groups showed statistically significant improvements in GMFM scores from baseline to post-treatment.
- Significant differences in total GMFM scores were observed between the groups after the intervention.
- The hinged AFO group demonstrated greater improvements compared to both the solid AFO and control groups.
Conclusions:
- Both hinged and solid AFOs, when combined with occupational therapy, enhance gross motor function in children with spastic diplegia.
- Hinged AFOs appear to offer superior benefits for gross motor function compared to solid AFOs and occupational therapy alone.
- Hinged AFOs represent a promising intervention for improving mobility and functional outcomes in this pediatric population.
Objective:
The purpose of this study was to examine the impacts of hinged and solid anklefoot orthoses (AFOs) on standing and walking abilities in children with spastic diplegia.
Materials & Methods:
In a quasi-experimental design, 30 children with spastic diplegia, aged 4-6 years were recruited. They were matched in terms of age, IQ, and level of GMFCS E&R. Children were randomly assigned into 3 groups: a hinged AFO group (n=10) plus occupational therapy (OT), a solid AFO group (n=10) plus OT, a control group who used only OT for three months. Gross motor abilities were measured using Gross Motor Measure Function (GMFM).
Results:
We obtained statistically significant differences in the values between baseline and after treatment in all groups. The groups were also significantly different in total GMFM after intervention. Furthermore, there were differences between hinged AFOs and solid AFOs groups, and between hinged AFOs and control groups.
Conclusion:
We concluded that gross motor function was improved in all groups; however, hinged AFOs group appears to improve the gross motor function better than solid AFOs and control groups.
