Impact of optimized AFOs on functional outcomes in children with spastic cerebral palsy

PurposeThis study aimed to compare the immediate functional impact of wearing ankle foot orthoses (AFOs) designed using the Optimal Segment Kinematics and Alignment approach to Rehabilitation (OSKAR method) versus wearing standard ankle foot orthosis (AFO)-footwear in children with spastic diplegic cerebral palsy.MethodsTen participants, ages seven to 13 years, from local pediatric clinics in a large suburban area participated in the study. Each participant wore both types of orthoses in a randomized order. This was determined by participants choosing a sealed envelope containing a sticker indicating which orthosis to be worn for the first data collection. Participants were assessed using three functional outcome measures: 1) the Pediatric Balance Scale (PBS), 2) Standardized Walking Obstacle Course, and 3) the Six-Minute Walk Test. Non-parametric Wilcoxon signed rank tests were used to compare outcome scores between the two conditions.ResultsTotal scores on the PBS were significantly higher when wearing the OSKAR AFO-footwear combinations (AFOFCs) (median = 50.50) versus standard AFOFCs (median = 47.00), T = 26.50, p = 0.034, r = 0.95, but all other immediate functional scores were comparable between conditions.ConclusionsAFOFCs designed using the OSKAR method may improve functional balance and should be considered when determining the orthotic prescription. These exploratory findings emphasize the need for further investigation of the effectiveness of OSKAR AFOFCs in children with spastic diplegic cerebral palsy (CP).