Role of three side support ankle–foot orthosis in improving the balance in children with spastic diplegic cerebral palsy

Cerebral palsy (CP) is a heterogeneous group of permanent, non-progressive motor disorders of movement and posture. Ankle–foot orthoses (AFOs) are frequently prescribed to correct skeletal misalignments in spastic CP. The present study aims to evaluate the effect of the three side support ankle–foot orthosis on standing balance of the spastic diplegic CP children. Thirty spastic diplegic CP children participated in this study from both sexes. They were divided randomly into two age and sex matched groups: (Group I: study group and Group II: control group). The degree of spasticity was evaluated by passive movement for both limbs, while the child was completely relaxed. The Biodex stability system, was used for the assessment of the dynamic postural control of all diplegic children. Also the system measures the subject’s ability to control the platform’s angle of tilt. The patient’s performance is noted as stability index which represents the variance of the platform displacement in degrees. Every patient in the study group was exercised on three side support ankle–foot orthosis for 30 min, three times weekly, for 6 months, also they received the same therapeutic exercise program which was given to the control group. The results revealed no significant difference as regards the pre-treatment mean values of all stability indices in both the control and the study groups (P < 0.05). However comparison between post-treatment mean values of all stability indices in both groups showed significant improvement in favor of the study group (p < 0.05). In conclusion: Uses of the three side support ankle–foot orthosis in addition to physical exercise program is highly useful in rehabilitation of spastic diplegic cerebral palsy children as they enabled them to gain more balance control and postural reactions .