Exploring the rationale for prescribing ankle-foot orthoses and supramalleolar orthoses to children with cerebral palsy among pediatric orthotists in Australia.

Objectives: To explore the rationale for prescribing ankle-foot orthoses and supramalleolar orthoses in children with cerebral palsy among pediatric orthotists in Australia.

Methods: Purposive, convenience, and snowballing sampling were used to recruit pediatric orthotists across Australia. Semistructured interviews were recorded and transcribed. The data were independently coded to derive themes and subthemes with illustrative first-person quotes.

Results: Participants (n = 16) in the sample were diverse in their age, years of clinical experience, and state of residence reflecting the breadth of pediatric orthotists in Australia. Two themes were generated: rationale for orthotic prescription and alignment of prescription rationale with child/family goals. Experienced clinicians could clearly articulate the key factors that influence their orthotic prescription aligned to the reasons why children/families sought orthotic intervention. Early to mid-career clinicians found this more challenging.

Conclusions: The rationale for the orthotic prescription should be aligned with the child/family's treatment goals. With a clear focus on treatment goals, the rationale for prescribing either ankle-foot orthoses or supramalleolar orthoses could be clearer if clinicians focused on key primary factors (eg, presence of crouch gait) and then optimized the prescription using a range of secondary factors (eg, body mass).