Comparison of plastic/metal and leather/metal knee-ankle-foot orthoses

Fifteen children with bilateral lower limb disability were fit alternately with plastic/metal (PM) and leather/metal (LM) knee-ankle-foot orthoses. Fit was maintained by periodic growth adjustments. Gait, activities of daily living, and subjective reactions were gathered for each orthosis type. Despite previous anecdotal reports and expert opinion to the contrary, no overall differences were found between the two types of orthoses. Several specific differences were revealed, however; most children preferred the PM orthoses, saying they were lighter and more easily donned and doffed; the PM orthoses also controlled hip and knee sagittal motion and foot valgus/varus during gait more effectively. Individual biomechanical, neuromuscular and psychologic attributes of the disabled child must be carefully matched with the technical attributes of each orthotic option to effect an optimal prescription.