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Seattle Children’s Orthotic Study for Children with Cerebral Palsy

Seattle Children’s Orthotic Study for Children with Cerebral Palsy

Ambulatory children with cerebral palsy (CP) demonstrate altered lower limb biomechanical alignment in walking (e.g. excessive hip/knee flexion or equinus during stance) and experience walking activity limitations that negatively influence their ability to participate in day to day life. Ankle Foot Orthoses (AFO) are a fundamental rehabilitation strategy to facilitate walking in children with CP; yet, a review suggests that efficacy of the “traditional” solid AFO (TSAFO) in this population remains equivocal. A novel decision tree to guide orthotic prescription proposes a patient-specific method for adjusting AFO alignment and integrating footwear modifications (Ankle Foot Orthoses-Footwear Combinations, AFO-FC). This approach is based on visualizing the sagittal plane orientation of the ground reaction force vector with respect to lower limb segments during gait. The AFO-FC represents a paradigm shift in orthotic management as it accommodates ankle equinus contractures in a rigid AFO, reorients the tibial segment with a heel wedge under the AFO, and applies different heel, midsole and forefoot shoe modifications to restore lost ankle-foot rockers. The primary goal of AFO-FCs are to improve stability by facilitating more normal segment kinematics in single limb stance, decreasing hip/knee flexion. Despite their promise, evidence of an immediate positive effect on midstance alignment is limited, with no evidence of clinical effectiveness.

This proposal assesses the feasibility of using a randomized waitlist study to acquire pilot data on a targeted clinical cohort of children with CP evaluating the effectiveness of AFO-FCs as compared to TSAFO during daily life. Individual joint and combined kinematics and kinetics will be examined for potential mechanisms of action as well as daily walking performance, balance and satisfaction with the AFO-FC in 30 ambulatory children with CP, ages 4-9 years, with bilateral crouch or equinus gait pattern, comparing gait in TSAFO to the AFO-FCs.

Participant Eligibility

•Between 4 and 9 years old
•Have bilateral spastic cerebral palsy
•Walk with or without support as a primary means of mobility


Tony To
(206) 884-7883

Additional Study Details

Full Study Title
Biomechanics and Walking in Cerebral Palsy: Ankle Foot Orthoses – Footwear Combinations

Study ID: STUDY00001393
Start Date: 08/31/2018
End Date: 03/24/2021

Kristie Bjornson, PT, PhD, MS

Accepts Healthy Volunteers?

Study Site(s)

Orthocare Innovations

123 2nd Ave S #220
Edmonds, Washington 98020


Use the link below to send a message to the study coordinator, or call the number above to speak directly with a study representative.

I am interested in this research study.