{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:05:51Z","timestamp":1787018751676,"version":"build-2736575974"},"reference-count":30,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2014,7,31]],"date-time":"2014-07-31T00:00:00Z","timestamp":1406764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Rehabil"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To examine whether using a knee-ankle-foot orthosis helps maintain ankle-foot dorsiflexion range of motion over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A multicentre randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Two hospitals and one rehabilitation centre in the Netherlands and the USA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects:<\/jats:title>\n                    <jats:p>Children (4-16 years old) with spastic cerebral palsy who were able to walk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention:<\/jats:title>\n                    <jats:p>\n                      Use of a knee-ankle-foot orthosis, equipped with an Ultraflex\n                      <jats:sup>\u00ae<\/jats:sup>\n                      ankle power unit, for at least 6 hours every other night for one year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main measures:<\/jats:title>\n                    <jats:p>Primary outcome measure: ankle-foot dorsiflexion range of motion. Secondary outcome measures: ankle-foot and knee angle in gait and gross motor function. Wearing time was also measured. Measurements were taken at baseline and at 3, 6, 9 and 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>28 children (experimental group: n=15, control group: n=13) participated in the study. 11 participants (experimental: n=4, control: n=7) did not complete all five measurements, as they needed additional treatment. No significant difference was found in the decrease of ankle-foot dorsiflexion range of motion between the experimental and control groups (difference: \u22121.05\u00b0, 95% confidence interval: \u22124.71\u00b0 \u2013 2.61\u00b0). In addition, secondary outcome measures did not show differences between groups. Despite good motivation, knee-ankle-foot orthosis wearing time was limited to a mean\u00b1SD of 3.2\u00b11.9 hours per prescribed night due to discomfort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Knee-ankle-foot orthosis with dynamic ankle and fixed knee are poorly tolerated and are not beneficial in preventing a reduction in ankle-foot dorsiflexion range of motion in children with spastic cerebral palsy, at least with limited use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0269215514542355","type":"journal-article","created":{"date-parts":[[2014,8,1]],"date-time":"2014-08-01T03:05:45Z","timestamp":1406862345000},"page":"1025-1038","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":25,"title":["A randomized controlled trial studying efficacy and tolerance of a knee-ankle-foot orthosis used to prevent equinus in children with spastic cerebral palsy"],"prefix":"10.1177","volume":"28","author":[{"given":"JC","family":"Maas","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam and the EMGO+ Institute for Health and Care Research, VU University Medical Center, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AJ","family":"Dallmeijer","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam and the EMGO+ Institute for Health and Care Research, VU University Medical Center, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PA","family":"Huijing","sequence":"additional","affiliation":[{"name":"MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JE","family":"Brunstrom-Hernandez","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Pediatrics, Washington University School of Medicine, St. Louis Children\u2019s Hospital, St. Louis, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PJ","family":"van Kampen","sequence":"additional","affiliation":[{"name":"Medical Rehabilitation Center Groot Klimmendaal, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EAM","family":"Bolster","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam and the EMGO+ Institute for Health and Care Research, VU University Medical Center, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Dunn","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Pediatrics, Washington University School of Medicine, St. Louis Children\u2019s Hospital, St. Louis, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Herndon","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Pediatrics, Washington University School of Medicine, St. Louis Children\u2019s Hospital, St. Louis, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RT","family":"Jaspers","sequence":"additional","affiliation":[{"name":"MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JG","family":"Becher","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam and the EMGO+ Institute for Health and Care Research, VU University Medical Center, the 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