Effect of ankle-foot orthoses on gait in typically developing children: Developmental trend in segmental coordination

Objective: As orthoses, and particularly ankle-foot orthoses, are widely used in the management of children with motor disorders, including cerebral palsy, we aimed to study their effect in normal children in order to add to normative gait data, which are essential for diagnosing, understanding and treating abnormal gait patterns. Design: We analyzed the effect of ankle-foot orthoses on classical gait parameters and lower limb segments coordination patterns in typically developing children in two age groups reflecting different neuromaturational/developmental situations. We recorded 3D kinematic gait patterns in 9 children (4-5 years) and 11 children (9-10 years) walking barefoot or wearing bilateral solid ankle-foot orthoses maintaining the ankle joint angle at a neutral position. Results: Ankle-foot orthoses induced little change in cadence, step length, step width or walking velocity in younger children, though they altered intralimb coordination through the gait cycle. In older children, walking velocity was reduced, shank elevation amplitude increased, while lower limb coordination changed less significantly. In this age group, ankle-foot orthoses significantly reduced the variability of coordinative strategies. Conclusion: Ankle-foot orthoses affect the gait pattern in children with a typical development at different levels in younger and older subjects, but the resulting changes are minimal.