Effects of wedged shoes and ankle-foot orthoses on standing balance and knee extension in children with cerebral palsy who crouch

Pediatr Phys Ther. Winter 2003;15(4):221-31. doi: 10.1097/01.PEP.0000096383.80789.A4.


Purpose: Effects of wedged shoes with solid ankle-foot orthoses (WAFOs) on standing balance (SB) were evaluated, as well as effects of AFOs alone on knee extension (KE) in children with cerebral palsy who crouch.

Methods: Using a repeated-measures design, 11 children (four to 13 years old) were tested four times at two-week intervals. AFO intervention comprised the first four weeks and WAFO intervention the second four weeks. SB and KE were measured during three conditions at each visit: no orthoses (NO), AFO, and WAFO. Test-retest reliability and AFO effects on KE were examined after the first month. WAFO effects on SB were examined after the second month.

Results: Intraclass correlation coefficients for KE were 0.89 (NO), 0.83 (AFO), and 0.81 (WAFO), and for SB, they were 0.98 (NO), 0.98 (AFO), and 0.97 (WAFO). Paired t tests for KE after AFO intervention were not significant. Restricted maximum likelihood estimations for SB were not significant. A post hoc power analysis of 68% suggested a type II error.

Conclusion: Further study is warranted to establish efficacy.