Comparison of a dynamic and a hinged ankle-foot orthosis by gait analysis in patients with hemiplegic cerebral palsy.

We studied the effect of a dynamic ankle-foot orthosis (d-AFO) on gait in 12 hemiplegic cerebral palsy patients. Sagittal plane kinematic and kinetic data of walking with the d-AFO were compared with walking barefoot, walking in a hinged ankle-foot orthosis (h-AFO) with a plantarflexion block and normal values. All patients had excessive plantarflexion and initial toe contact when walking barefoot. The d-AFO did not improve gait significantly whereas the h-AFO did. The benefits of controlling plantarflexion by a longer lever arm fror the h-AFO to the proximal calf included a heel-toe gait pattern, reduced plantarflexion, increased step and stride length and reduced power absorption.