Development of clinical considerations for ankle-foot orthosis prescription and monitoring in young children with cerebral palsy: a Delphi study.

Abstract

To seek agreement on evidence-based, family-centered, clinical considerations for Ankle Foot Orthosis (AFO) prescription and monitoring for young, ambulatory children with cerebral palsy. An online Delphi survey focusing on parent, clinician, and researcher perspectives on specific processes and outcomes concerning AFO prescription and monitoring practices was conducted over two rounds. Participants rated each survey item as critical, important but not critical, or less important. Items were included in Round 2 if >70% of participants in all three groups scored critical and <15% scored less important. A subgroup of survey respondents participated in a meeting to ratify the survey results. Twenty-two pediatric clinicians, seven researchers, and ten parents of young children with cerebral palsy participated in Round 1. Two clinicians and two parents dropped out in the second round. A total of 36 clinical considerations were deemed to be critically important for inclusion across contributor groups. The proposed clinical considerations for AFO prescription and monitoring that embeds the perspectives of families is a valuable contribution to clinical practice. They can be used by clinicians as a guide when prescribing and introducing AFOs to families of young, ambulatory children with cerebral palsy.