Comparison of Two Ankle Foot Orthosis on Mobility, Participation and Adhesion in Childrend With Cerebral Palsy

This study is a randomized controlled trial with a crossover design. A total of 38 patients will be recruited from three different centers.

Each participant will be randomly assigned to one of two groups (Group c/pl or Group pl/c). Depending on the group allocation, each subject will test both types of ankle-foot orthoses (AFOs) in a different order.

• Group c/pl: Participants in Group A will first use the carbon AFO (c-AFO) for four weeks. Evaluations will be conducted before and after this period. After a washout phase, they will then use the plastic AFO (pl-AFO) for another four weeks, with evaluations conducted before and after this second phase.
• Group pl/c: Participants in Group B will follow the same protocol, but in reverse order: starting with the pl-AFO for four weeks (with pre- and post-evaluations), followed by a washout period and then four weeks with the c-AFO (again with evaluations before and after).

Each evaluation includes:

• A quantitative gait analysis including ground reaction force measurements, kinematic data, and spatiotemporal parameters.
• Clinical tests to assess functional mobility and endurance.
• Questionnaires to evaluate participation levels, satisfaction, and acceptance of the AFOs.

Inclusion criteria

• Children from 8 to 15 years old
• Spastic, hemiparetic cerebral palsy
• Level I or II on the Gross Motor Function Classification System
• Ability to walk and run 10 meters without assistance
• Ability to jump (simultaneous lift of both feet)
• Daily use of a plastic ankle foot orthosis allowing ankle mobility
• Affiliated to a social security scheme

Exclusion criteria

• Children with ataxic, dyskinetic, or mixed-type cerebral palsy
• Children with cognitive, intellectual, or behavioral disorders that may impair their understanding of instructions, the proper conduct of evaluations, or the use of assessment scales, as judged by the investigator.
• Children who have received botulinum toxin injections within 4 months prior to the inclusion visit
• Children or adolescents who have undergone surgical intervention:

within the past 6 months prior to inclusion if no bony procedure was performed, or within the past 12 months prior to inclusion if a bony procedure was performed, or who have a planned surgical procedure during the study period.

• Children who have participated in an intensive rehabilitation program within 4 months prior to the inclusion visit
• Children or adolescents participating in another interventional study that could interfere with the outcomes of the present study by altering the subject's physical abilities.