Ankle Foot Orthoses (AFO) are a fundamental strategy to facilitate walking in children with CP; yet, reviews (Neto, 2012; Aboutorabi, 2018), suggest that efficacy of the """"traditional"""" solid AFO (TSAFO) remains equivocal. A novel decision tree to guide orthotic prescription has proposed a patient-specific method for adjusting alignment of solid AFOs and integrated footwear (Ankle Foot Orthoses-Footwear Combinations, AFO-FC, Owen, 2010). This study examines the effect of AFO-FC on daily walking activity levels and intensity as compared to the TSAFO (no alignment or shoe modifications) in children with CP

Learning Objectives:

• Describe the walking activity level (strides/day) and intensity (time in moderate/high stride rates) of children with cerebral palsy as compared to typically developing children.
• Name a wearable device that can be employed clinically or in research to capture walking activity in daily life.
• Review the pilot walking activity results comparing a traditional solid ankle foot orthoses as compared to the ankle foot orthoses-footwear combination (AFOFC) approach.
• Review the walking activity data presented in this pilot study in relation to the published normative walking activity data for children with cerebral palsy.

Effects Of Carbon Fiber Ankle Foot Orthosis Use To Prevent Post-Traumatic Ankle Osteoarthritis

An individual at increased risk for developing post-traumatic osteoarthritis due to an ankle fracture completed a computerized gait analysis while wearing three carbon fiber custom dynamic ankle foot orthoses of different designs and stiffnesses. Using computational modeling, all three devices were found to reduce muscle forces, joint reaction force, and ankle contact stress during gait, potentially reducing the individuals' risk of developing post-traumatic arthritis.

Learning Objectives:

• Describe mechanical factors associated with the development of post-traumatic osteoarthritis following intra-articular ankle fracture.
• Describe how joint loading (and offloading) can be evaluated using gait analysis and computer modeling.
• Explain how carbon fiber custom dynamic orthoses could potentially reduce the risk of developing post-traumatic osteoarthritis after ankle fracture.

Gait Outcomes Assessment List (Goal): Randomized Pilot Trial Of Orthotic Management In Cerebral Palsy

Kristie Bjornson, PT, PhD, MS

Ambulatory children with Cerebral Palsy (CP) demonstrate altered lower limb biomechanical alignment in walking and experience activity limitations that negatively influence their ability to participate in daily life. A fundamental strategy to facilitate walking in children with CP are Ankle Foot Orthoses (AFO). Reviews suggest equivocal evidence for efficacy of the """"traditional"""" solid AFO (TSAFO). A patient specific algorithm of orthotic prescription (Owen, 2010) proposes a method for AFO alignment combined with footwear modifications (Ankle Foot Orthoses-Footwear Combinations, AFO-FC). This study examined the effect of the AFO-FC on parent-reported gait priorities and functional mobility compared to the TSAFO (without shoe modifications).

Learning Objectives:

• Name a parent/patient reported outcome of walking function and gait priorities appropriate for orthotic interventions in children with cerebral palsy.
• Describe the results of this pilot study comparing traditional solid ankle foot orthoses and the ankle foot orthoses-footwear combination (AFO-FC) approach.
• Discuss how this pilot study describes treatment effectiveness (how intervention works in daily life/clinical practice) as compared to efficacy (how an intervention works in a structured controlled lab setting i.e. gait lab).

Goal-Setting Tool For Children Who Use Ankle-Foot Orthoses: A modified Delphi Study

Table and Pictorial Tool containing goals for children who use Ankle-Foot Orthoses, in all areas of the World Health Organization ICF, had content validity established by a modified Delphi consensus.

Learning Objectives:

• Upon completion, participant will be able to describe and discuss the content validation of a novel Table and Pictorial Tool, which lays out the potential goals for orthotic interventions with Ankle-Foot Orthoses for all areas of the International Classification of Functioning Disability and Health (ICF & ICF-CY, WHO 2001& 2007). 
• Discuss the usefulness of these Tools for developing collaborative goal setting with multidisciplinary /inter-professional team colleagues and families.
• Debate the potential use of the Table and Pictorial Tool for future research and educational purposes.
• Upon completion, participant will be able to discuss the usefulness of the presented Table and Pictorial Tool for developing collaborative goal setting with their multidisciplinary / inter-professional team colleagues and families.
• Upon completion, participant will be able to debate the potential use of the presented Table and Pictorial Tool for future research and educational purposes.