Ankle-foot orthoses for preambulatory children with spastic diplegia

We evaluated the effect of articulating and solid ankle-foot orthoses (AFOs) on the transitional movement of sit-to-stand for 15 children aged 2-5 years with spastic diplegia and dynamic equinus. Kinematic and kinetic data were collected for each child. The time to reach stable standing was determined by using a force plate. Seven children were comparable to age-matched normals while barefoot and were slowed by the use of AFOs. Eight patients were more than 1 standard deviation slower than normals while barefoot. All were significantly (p < 0.003) improved by the use of articulating AFOs. The clinical difference between these groups was the presence of equinus during stable standing while barefoot for patients aided by AFOs, whereas the second group remained plantigrade barefoot. We conclude that children with spastic diplegia with uncontrolled dynamic equinus benefit from the use of articulating AFOs for the movement of sit-to-stand.