Trial reportPloS one2015
The Effects of Varying Ankle Foot Orthosis Stiffness on Gait in Children with Spastic Cerebral Palsy Who Walk with Excessive Knee Flexion.
Trial report in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 118 citations in OpenAlex.
- Relationship between ankle function and walking ability for children and young adults with cerebral palsy: A systematic review of deficits and targeted interventions.Gait & posture · 2022Pooled it
- Differential and Adjustable Stiffness Leaf Spring Ankle Foot Orthoses Enhance Gait Propulsion and Task Versatility in Cerebral Palsy.Annals of biomedical engineering · 2025Trial
- Modifying ankle foot orthosis stiffness in patients with calf muscle weakness: gait responses on group and individual level.Journal of neuroengineering and rehabilitation · 2019Trial
- Comparison of Direct 3D Scans and Plaster Casts in Digital Ankle-Foot Orthosis Workflows.Medical sciences (Basel, Switzerland) · 2026Article
- The variable stiffness orthosis: customizable mechanics for assistance and rehabilitation.Journal of neuroengineering and rehabilitation · 2026Article
- An integrated multi-variable optimization approach to tailor ankle-foot orthosis stiffness to end-user needs.Journal of neuroengineering and rehabilitation · 2026Article
- The Utilization of a Gait Pattern Classification System to Investigate the Effects of Ankle-Foot Orthoses on Gait in Children with Cerebral Palsy.Children (Basel, Switzerland) · 2026Article
- Awareness, Framework-Based Proficiency, and Clinical Implementation of Ankle Foot Orthosis-Footwear Combination (AFO-FC) Tuning: A Cross-Sectional Survey.Journal of clinical medicine · 2026Article
- Determinants of demand for intelligent ankle-foot orthoses in children with cerebral palsy: a multicenter cross-sectional study from a multi-stakeholder perspective.Frontiers in public health · 2026Article
- A usability study on the inGAIT-VSO: effects of a variable-stiffness ankle-foot orthosis on the walking performance of children with cerebral palsy.Journal of neuroengineering and rehabilitation · 2024Article
- Customized passive-dynamic ankle-foot orthoses can improve walking economy and speed for many individuals post-stroke.Journal of neuroengineering and rehabilitation · 2024Article
- Quantifying changes in individual-specific template-based representations of center-of-mass dynamics during walking with ankle exoskeletons using Hybrid-SINDy.Scientific reports · 2024Article
- The interaction between muscle pathophysiology, body mass, walking speed and ankle foot orthosis stiffness on walking energy cost: a predictive simulation study.Journal of neuroengineering and rehabilitation · 2023Article
- Perspectives on ankle-foot technology for improving gait performance of children with Cerebral Palsy in daily-life: requirements, needs and wishes.Journal of neuroengineering and rehabilitation · 2023Article
- A machine learning approach to quantify individual gait responses to ankle exoskeletons.bioRxiv : the preprint server for biology · 2023Article
- Advances on mechanical designs for assistive ankle-foot orthoses.Frontiers in bioengineering and biotechnology · 2023Review
- The Use of the 6MWT for Rehabilitation in Children with Cerebral Palsy: A Narrative Review.Journal of personalized medicine · 2022Review
- Investigation of neural and biomechanical impairments leading to pathological toe and heel gaits using neuromusculoskeletal modelling.The Journal of physiology · 2022Article
- Design principles, manufacturing and evaluation techniques of custom dynamic ankle-foot orthoses: a review study.Journal of foot and ankle research · 2022Review
- Metabolically efficient walking assistance using optimized timed forces at the waist.Science robotics · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRigid Ankle-Foot Orthoses (AFOs) are commonly prescribed to counteract excessive knee flexion during the stance phase of gait in children with cerebral palsy (CP). While rigid AFOs may normalize knee kinematics and kinetics effectively, it has the disadvantage of impeding push-off power. A spring-like AFO may enhance push-off power, which may come at the cost of reducing the knee flexion less effectively. Optimizing this trade-off between enhancing push-off power and normalizing knee flexion in stance is expected to maximize gait efficiency. This study investigated the effects of varying AFO stiffness on gait biomechanics and efficiency in children with CP who walk with excessive knee flexion in stance. Fifteen children with spastic CP (11 boys, 10±2 years) were prescribed with a ventral shell spring-hinged AFO (vAFO). The hinge was set into a rigid, or spring-like setting, using both a stiff and flexible performance. At baseline (i.e. shoes-only) and for each vAFO, a 3D-gait analysis and 6-minute walk test with breath-gas analysis were performed at comfortable speed. Lower limb joint kinematics and kinetics were calculated. From the 6-minute walk test, walking speed and the net energy cost were determined. A generalized estimation equation (p<0.05) was used to analyze the effects of different conditions. Compared to shoes-only, all vAFOs improved the knee angle and net moment similarly. Ankle power generation and work were preserved only by the spring-like vAFOs. All vAFOs decreased the net energy cost compared to shoes-only, but no differences were found between vAFOs, showing that the effects of spring-like vAFOs to promote push-off power did not lead to greater reductions in walking energy cost. These findings suggest that, in this specific group of children with spastic CP, the vAFO stiffness that maximizes gait efficiency is primarily determined by its effect on knee kinematics and kinetics rather than by its effect on push-off power.
trial registrationDutch Trial Register NTR3418.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.