Effectiveness of AFO orthoses in children affected by cerebral palsy: Clinical evaluation does not always define patient satisfaction

alking. Healthy young subject were asked to mimic voluntarily nterior pelvic tilt during gait analysis sessions. Materials andmethods: Six healthy young adults (29±3 years ld) performed a gait analysis along a 12 meters walkway bareoot. After that, they were asked to mimic anterior pelvic tilt, Fig . Data were collected with Vicon Mx system with 8 cameras, two MTIOR6-5 forceplatformsandWave surfaceEMGsystem. Spatioemporal parameters, kinematic, kinetic and surface EMG of four ait cycles were analyzed, comparing self placed barefoot gait with oluntary anterior pelvic tilt one. Digital video acquisitions were lso performed. Results: Videoobservation:duringvoluntary anteriorpelvic tilt, he trunk tilted forward, the upper limbs tilted backward, the foot ontact was flat or on toe, Fig. 1. Kinematic: in comparison with barefoot gait the main diferences were the ankle plantar-flexion at foot contact, the nticipation of ankle plantar-flexion during late stance, a reduced aximum of knee flexion during swing, an increased hip flexion nd, of course, the requested increased anterior pelvic tilt. Kinetic: double bump and reduction of ankle dorsal-flexion oment, increased ankle power absorption and generation during arly stance, and reduced ankle power generation in late stance as observed, Fig. 2. Spatio-temporal parameters: the cadence increased from 24±5.11 steps/min to 145±14.4 steps/min; the stride time ecreased from 0.96±0.040 s to 0.84±0.078 s and consequently alking speed increased from 1.34±0.11 m/s to 1.57±0.26 m/s. he other spatio-temporal variables did not differ. EMG: triceps enveloped surface EMG diagram showed anticipaion of triceps activation during voluntary tilt, Fig. 3. Discussion: Voluntary anterior pelvic tilt facilitated the forward rojection of the upper bodywith the association of a not requested oewalking like behaviour. The kinematic, kinetic, spatio-temporal nd EMG parameters showed a pattern similar with the gait of toealkers. From the results of this work it is possible to hypothesize hat anterior pelvic tilt could be considered one of the elements acilitating toe walking. The whole body biomechanical configuation contributes to the aetiology of gait strategies. The selected daptive solution for balancing thepelvis could constrain alsodistal egments configurations.