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



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.


Heterogeneity was observed across included studies in measurement, implementation, and study rigor.


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.


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Correspondence to Walaa Abd El-Hakiem Abd El-Nabie PhD.

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El-Hakiem Abd El-Nabie, W., Abd El Aziz, H. & Elshennawy, S. Effect of walking aids and foot orthoses on energy expenditure in children with cerebral palsy: a systematic review. Bull Fac Phys Ther 24, 99–112 (2019).

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  • cerebral palsy
  • energy expenditure
  • orthosis
  • systematic review
  • walking aids