Orthotic bracing to treat equinus in children with spastic cerebral palsy: Recorded compliance and impact of wearing time

Abstract

Aim

Spastic cerebral palsy (SCP) often results in "pes equinus," managed with ankle-foot orthoses (AFOs). Yet, little is known about actual wearing time and the minimum duration for improvement. This study explores orthotic compliance, examining its impact on clinical and gait parameters. The hypothesis anticipates a compliance rate below 50 %, suggesting AFOs worn for over 6 hours enhance ankle dorsiflexion.

Method

In a clinically prospective study, SCP children (ages 5 – 15 years) with equinus underwent gait analysis at recruitment and three months later. Wearing time, measured by sensors, categorised participants into compliant (≥6 hours) and non-compliant (<6 hours) groups.

Results

Data were obtained for 32 participants (21 males, 11 females; mean age 10 years 7 months [SD 3 years]). Among 32 participants, 47 % wore AFOs over 6 hours, showing significant ankle dorsiflexion improvement. Thigh shell wearing time was shorter; only two exceeded 6 hours during the day.

Interpretation

Confirming our hypothesis, compliance was < 50 %, yet AFOs over 6 hours improved ankle dorsiflexion. The study revealed minimal AFO daytime use and thigh shell acceptance. Wearing time significantly impacted equinus deformity, underscoring the need to identify factors influencing compliance for effective measures to extend usage.