Effect of walking aids and foot orthoses on energy expenditure in children with cerebral palsy: a systematic review

Background Walking aids and ankle–foot orthoses (AFOs) are designed to address gait problems. These devices are common among children with cerebral palsy (CP), as those children’s ability to ambulate is a big concern for their parents, and its improvement is considered primary focus of therapeutic modalities addressing motor disorders of this population. However, empirical support for walking aids and AFO is limited. The aim of this review was to assess the quality of research on the effect of walking aids and AFO on energy expenditure in children with CP. Materials and methods Four electronic databases using predefined terms were searched by two independent reviewers. All study designs except case reports were included. Nineteen studies involving 509 participants met inclusion criteria and were involved in this review. Results Heterogeneity was observed across included studies in measurement, implementation, and study rigor. Conclusion There is a need for high-quality studies to draw a clear conclusion on the effect of walking aids and AFO on energy expenditure in children with CP; the typical flaws of existing studies included weak experimental designs, insubstantial treatment outcomes, and high risk of bias.