Effects of dynamic ankle-foot orthoses on standing in children with severe spastic diplegia

The aim of this study was to investigate whether wearing a dynamic ankle-foot orthosis (DAFO) improved standing posture in six children with severe spastic diplegia. Kinematics and ground reaction forces were recorded with a three-dimensional optoelectronic movement analysis system and two force plates. The results revealed that on a group level, DAFOs did not improve standing posture, distribution of body weight or lateral standing stability as reflected in the horizontal ground reaction forces. However, some children could benefit from the use of a DAFO through a more equal weight distribution and improved sagittal position of the knee, compared to wearing shoes alone. According to the heterogeneous clinical signs and symptoms in children with severe spastic diplegia, studies on a group level easily lead to negative findings and therefore individual benefits could be showed by using single case designs.