Effects of Orthoses on Standing Postural Control and Muscle Activity in Children With Cerebral Palsy.

The study included only 10 participants and measured 12 dependent variables, so it had limited power. The sample was a convenience sample with a wide age range and nonuniform prescribed orthoses. Eligibility required the child to stand independently for 10 seconds barefoot, so the findings may not apply to children who cannot stand briefly. The three conditions were tested in a fixed order, custom orthosis, bare feet, then usual AFO, although the authors analyzed order effects. No statistical adjustments were made for multiple comparisons. The study cannot identify which component mattered: ankle-foot restriction, shank alignment, or both. Electromyography did not support the hypothesized decrease in muscle activity or proximal-to-distal change, and the custom orthosis was a novel experience compared with the familiar AFO.

The authors declared no conflicts of interest. The article is listed as NIH extramural research support.

Do not conclude that the orthosis made standing less effortful. The electromyography data did not show lower overall muscle activity or a more typical proximal-to-distal pattern with the new orthosis, and the study could not separate the effects of ankle-foot restriction and shank alignment.