A Review of Knee-Ankle-Foot Orthoses in Managing Neuromuscular Disorders: Focus on Children with Cerebral Palsy

Naif Saad Alsuwayti ¹, Meshari Farzal Ashwi Alshammari ^2*, Nahla maan aljuwaie ³, Entsar Yusuf Salah Alhosawy ⁴, Asma yousef saleh ALHawsawi ⁵, Fatimah sultan Aedh Alghamdi ⁶, Mohammed Saleh Ali Alshehri ⁷, Saleh said saleh alhamdan ⁸, Nawaf Abdullah Rashed Alqinat 9, Bashaier Ayed Alshahrani 10, Abdullah saeid Mohamed Asiry 11, Khalid Ali Sayqal Qawfash 12, Khalid Obaid L Alanazi 13

Neuromuscular disorders significantly impair mobility and stability; advanced orthoses like SCKAFOs improve walking efficiency and knee stability, enhancing life quality.

Abstract

Neuromuscular disorders (NMDs) significantly impact the musculoskeletal system, leading to lower extremity muscle weakness and impaired coordination, notably affecting the quadriceps. These impairments compromise knee stability during standing and walking, increasing fall risks and hindering mobility and independence. Knee-ankle-foot orthoses (KAFOs) are vital in enhancing gait efficiency and knee stability. Traditional locked KAFOs rigidly immobilize the knee throughout the gait cycle, offering maximal stability but limited natural movement. Advances in orthotic technology have led to the development of stance control KAFOs (SCKAFOs), which dynamically lock the knee only during the stance phase, promoting a more natural and energy-efficient gait. The E-MAG Active and NEURO TRONIC knee joints are prominent examples of SCKAFOs, featuring sophisticated electronic control mechanisms to improve functional outcomes in individuals with NMDs. This review also focuses on the application of SCKAFOs in children with cerebral palsy (CP), the most common neuromotor disorder affecting movement, posture, and muscle tone due to early brain injury. The prevalence and diverse etiologies of CP necessitate individualized therapeutic interventions. The review aims to evaluate the efficacy and satisfaction of orthotic management in pediatric CP, providing evidence-based recommendations for optimizing orthotic interventions and enhancing quality of life for affected children and their families.

Keywords: Knee-ankle-foot orthoses (KAFOs), Stance control KAFOs (SCKAFOs), E-MAG Active knee joint, NEURO TRONIC knee joint, Children with cerebral palsy (CP)

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