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Comparison of Articulated and Rigid Ankle-Foot Orthoses in Children With Cerebral Palsy: A Systematic Review

Neto, Hugo Pasini PhD; Grecco, Luanda André Collange MS; Galli, Manuella PhD; Oliveira, Claudia Santos PhD

doi: 10.1097/PEP.0b013e318268a4fc
Review Article

Purpose: The aim of this review was to compare the effects of rigid and articulated ankle-foot orthoses on gait in children with cerebral palsy (CP).

Method: A systematic review was carried out in 4 databases. The papers identified were evaluated on the basis of the following inclusion criteria: (1) design—controlled clinical trial; (2) population—children and adolescents with CP; (3) intervention—rigid or articulated ankle-foot orthoses; and (4) outcome—improved motor function and gait performance.

Results: Seven controlled studies comparing the effects of different ankle-foot orthoses were found. Studies achieved PEDro scores of 3 and 4 for methodological quality.

Conclusion: There is evidence supporting the use of an articulated ankle-foot orthosis by children with CP, because of the improved function this type of orthosis provides. However, other studies point out the advantages of a rigid orthosis for children with greater impairment related to spasticity and contractures.

This systematic review of the effect of rigid and articulated orthoses reveals that articulated orthoses can improve function, but rigid orthoses may be preferable for children with more severe impairments, including spasticity and contractures.

Rehabilitation Sciences Department, Universidade Nove de Julho, São Paulo, Brazil (Drs Neto and Santos Oliveira and Ms Collange Grecco); Bioengineering Department, Politecnico di Milano, Milan, Italy (Dr Galli).

Hugo Pasini Neto, PhD, Ave Presidente Kennedy, 189 apto. 52 - Jd. Paulistano, CEP- 18040-550 - Sorocaba, SP, Brazil (

The authors declare no conflict of interest.

© 2012 Lippincott Williams & Wilkins, Inc.