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Forefoot Mobility in Ankle and Foot Orthoses: Effect on Gait of Children With Cerebral Palsy

Carmick, Judy PT, MA

doi: 10.1097/PEP.0b013e31828e30ac
Case Report

Background and Purpose: Typical gait requires flexibility in the ankle and foot. During gait, it is critical that the ankle dorsiflex and the toes extend. The purpose of this report is to demonstrate that when foot orthoses block critical movement undesirable compensations that may interfere with gait can appear.

Case Description: Three children with spastic cerebral palsy demonstrate the effect on gait when the blocks attributable to the orthoses were removed.

Intervention: All children received electrical stimulation and used foot orthoses.

Outcomes: Internal hip rotation and toe walking occurred when orthoses blocked digit extension. A block may be small and unnoticed but can still influence gait and force the child to compensate for the loss of mobility.

The author describes the effect of orthotic fit on forefoot mobility in 3 children with cerebral palsy. Small changes in orthotic fit influenced the children's gait.

Private Practice, Alamo, California.

Correspondence: Judy Carmick, PT, MA, 3060 Miranda Ave, Alamo, CA 94507 (

The author declares no conflicts of interest.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins and the Section on Pediatrics of the American Physical Therapy Association.