Analysis of the gait of children with cerebral palsy with and without using ankle and foot orthoses

AIMS: To analyze the linear parameters of the gait of children with spastic hemiparetic cerebral palsy, users of articulated ankle and foot orthoses. METHODS: A three-dimensional analysis of the gait of eight children with spastic hemiparetic cerebral palsy, aged 5 to 10 years, classified in levels I and II of the Gross Motor Function Classification System, was made with and without the use of ankle and foot orthoses. A kinematic system with seven integrated cameras captured the three-dimensional trajectory of markers in the participants' body during gait, with data being collected at a sampling rate of 100 Hz. For the comparisons, the paired t-test and the t-test for a sample were used. RESULTS: Considering the gait's spatiotemporal variables of these children with cerebral palsy compared to normal values, only velocity (with the orthosis and without the orthoses) presented a statistically significant difference. The mean normal gait velocity is 1.25 m/s, while in the non-orthoses participants the mean velocity was 0.98 +/- 0.10 m/s (p=0.0001) and with the use of orthoses the mean velocity was 0.96 +/- 0.21 m/s (p=0.0001). In the comparison between children using or not the ankle and foot orthoses, velocity, cadence and pitch length were respectively 0.98 +/- 0.10 m/s, 131 +/- 16.15 steps/min and 0.44 +/- 0.08 m in the children without the orthoses; and 0.96 +/- 0.21 m/s, 128.37 +/- 22.9 steps/min and 0.48 +/- 0.05 m in the children with the orthoses. The differences were not statistically significant. CONCLUSIONS: Comparison between the same group with and without the use of ankle and foot orthoses suggests that their use in children with cerebral palsy may promote an increase in step length and a decrease in velocity and cadence in relation to condition without orthosis, favouring a better distribution of weight in the paretic member and providing a better symmetry in gait. However, the differences were not statistically significant. Thus, it is expected that the results obtained in this study can serve as a pilot for future research, with larger samples.