Investigation of Parental Expectations Regarding Ankle–Foot Orthosis Use in Children Diagnosed with Cerebral Palsy: The Case of Şanlıurfa Province
Keywords:
Ankle–Foot Orthosis, Cerebral Palsy, Family Expectations, Orthosis Compliance, Pediatric RehabilitationAbstract
Purpose: The aim of this study was to evaluate the expectations of families of children with cerebral palsy (CP) who use ankle–foot orthoses (AFOs). Additionally, demographic characteristics of children with CP, socioeconomic status of their families, awareness levels regarding CP, expectations from treatment and orthosis use, and perceptions of orthosis appropriateness were investigated.
Methods: This cross-sectional study included voluntary parents of children aged 3–18 years with a diagnosis of CP who had been using an AFO for at least four months and were receiving treatment at special education and rehabilitation centers in Şanlıurfa, Türkiye. A total of 120 parents participated. Data were collected using a researcher-developed Parent Questionnaire Form including demographic information, socioeconomic status, knowledge about CP and orthosis use, orthosis compliance, satisfaction, and perceived benefits. Descriptive statistics and appropriate parametric and non-parametric analyses were performed using SPSS software.
Results: Night AFOs were used significantly longer than walking AFOs (p < 0.05). The majority of children (79.19%) used their orthoses regularly. The most commonly reported reasons for irregular use were discomfort, pain, sweating, and child reluctance. Parents demonstrated limited knowledge about CP and the context-dependent pain-reducing effects of AFOs, rather than a general analgesic effect. Overall, AFOs were found to meet family expectations at a moderate level.
Conclusion: Family–rehabilitation center collaboration is essential to minimize problems related to orthosis use in children with CP. Increasing parental knowledge regarding CP rehabilitation and AFO use may improve treatment compliance and outcomes. These findings may contribute to the development of clinical guidelines for physiotherapists.
References
1. El Ö, Peker MÖ, Bozan Ö, Berk H, Koşay C. Serebral palsi hastalarının genel özellikleri. DEÜ Tıp Fak Derg. 2007;21(2).
2. Günel MK. Rehabilitation of children with cerebral palsy from a physiotherapist's perspective. Acta Orthop Traumatol Turc. 2009;43(2):173–80.
3. Ofluoğlu D. Orthotic management in cerebral palsy. Acta Orthop Traumatol Turc. 2009;43(2):165–72.
4. Suckon CE, Thomas SS, Jakobson-Huston S, Moor M, Sussman M, Aiona M. Comparison of three ankle-foot orthosis configurations for children with spastic diplegia. Dev Med Child Neurol. 2004;46(9):590–8.
5. Refshauge KM, Raymond J, Nicholson G, Dolder PA. Night splinting for Charcot–Marie–Tooth disease: a randomised cross-over trial. Aust J Physiother. 2006;52:193–9.
6. Erel S, Şimşek LE, Bek N, Bayar B, Alan A, Yakut Y, et al. Çocuk hastalarda plastik ayak–ayak bileği ortezi görünümünün memnuniyet ve ortezi kabullenme üzerine etkisi. Fizyoter Rehabil. 2007;18(3):195–200.
7. Garg S, Porter K. Improved bracing compliance in children with clubfeet using a dynamic orthosis. J Child Orthop. 2009;3(4):271–6.
8. Davids JR, Rowan F, Davis RB. Indications for orthoses to improve gait in children with cerebral palsy. J Am Acad Orthop Surg. 2007;15:178–88.
9. .Field A. Discovering statistics using SPSS. 3rd ed. London: Sage Publications; 2009.
10. Dilek B, Gür G, Yakut Y. Factors affecting ankle-foot orthosis wearing time in children with cerebral palsy: a pilot study. J Exerc Ther Rehabil. 2015;2(2):47–52.
11. Ülkir O. Design and data-driven predictive control of an active ankle-foot orthosis [doctoral thesis]. Istanbul: Marmara University; 2019.
12. Dilek B. Investigation of factors affecting compliance with ankle-foot orthoses in children with cerebral palsy [master’s thesis]. Ankara: Hacettepe University, Institute of Health Sciences; 2010.
13. Altun M. The effect of socioeconomic and demographic characteristics on quality of life of parents of children with cerebral palsy living in Gaziosmanpaşa district of Istanbul [doctoral dissertation]. Istanbul: Institute of Health Sciences; 2014.
14. Näslund A, Tamm M, Eriessen AK. Dynamic ankle-foot orthoses as a part of treatment in children with spastic diplegia: parents’ perceptions. Physiother Res Int. 2003;8:59–68.
15. Jannink MJA, De Vries J, Stewart RE. Questionnaire for usability evaluation of orthopaedic shoes: construction and reliability in patients with degenerative disorders of the foot. J Rehabil Med. 2004;36:242–248.
16. Maas JC, Dallmeijer AJ, Oudshoorn BY, Bolster EA, Huijing PA, Jaspers RT, Becher JG. Measuring wearing time of knee-ankle-foot orthoses in children with cerebral palsy: comparison of parent-report and objective measurement. Disabil Rehabil. 2018;40(4):398–403.
17. Polliack AA, Eliot S, Landsberger SE. Lower extremity orthoses for children with myelomeningocele: user and orthotist perspectives. J Prosthet Orthot. 2001;13:123–133.
18. Shore BJ, Spence D, Graham HK. The role for hip surveillance in children with cerebral palsy. Curr Rev Musculoskelet Med. 2012;5(2):126–134.
19. Akyalçın S. Investigation of the effect of participation in activities on quality of life in children with cerebral palsy [thesis]. 2012.
20. Çankaya T, Özel A, Taş SA, Karabulut D, Tezcan S. Investigation of orthosis and assistive device satisfaction in individuals with chronic disabilities. Celal Bayar Univ J Health Sci Inst. 2020;7(1):35–40.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Nail Abidin Yaraşır, Muhammed Vedat Dusak, Kezban Yiğiter, Burcu Dilek, Yavuz Yakut
This work is licensed under a Creative Commons Attribution 4.0 International License.
