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Pediatr Phys Ther. 2003 Winter;15(4):221-31.

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

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Motion Analysis Laboratory, Children's Hospital, Richmond, VA 23220, USA.



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.


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.


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.


Further study is warranted to establish efficacy.

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