Study designs of evaluations included in the review
Controlled clinical trials were eligible. Randomised controlled trials (RCTs) and non-randomised controlled trials (prospective, cross-sectional and retrospective) in which the participant acted as their own control were included.
Specific interventions included in the review
Studies that compared any lower limb orthosis with an alternative, a control intervention, or no orthoses were eligible. The following types of orthoses were included: hybrid hinged; rigid tone reducing footplate; daytime ankle foot orthoses (AFO), including rigid and hinged; rigid; supramalleolar orthoses (temporary applications of casts were excluded), with and without a tone reducing footplate; hinged tone reducing footplate; supramalleolar dynamic AFO; metal Klenzack; posterior leaf spring AFO; dynamic AFO with plantarflexion stop; spiral graphite and hinged AFO, with and without tone reducing footplate and calf cut out. The control interventions predominantly involved measuring an activity barefoot or with shoes only.
Participants included in the review
Studies of children with CP were eligible. Studies that examined heterogeneous diagnoses, such as adults or children with head injuries, were excluded. The characteristics of the children were generally described as perambulatory, spastic CP (including diplegia and hemiplegia), and equinus (including dynamic equinus and users of orthoses). Most of the included children had spastic type CP.
Outcomes assessed in the review
The inclusion criteria were not defined in terms of outcomes. Most of the included studies assessed the outcomes using the Activity dimension of the International Classification of Impairment, Disability and Handicap (ICIDH-2; see Other Publications of Related Interest no.1). Other outcomes were also assessed: gait analysis, used to examine parameters of walking; standing balance; movement from sitting to standing; stair climbing; changes in Gross Motor Function Measure (see Other Publications of Related Interest no.2); a standardised walking obstacle course; range of joint movement; and X-rays to monitor foot and ankle alignment in orthoses.
How were decisions on the relevance of primary studies made?
The author did not state how the papers were selected for the review, or how many reviewers performed the selection.