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Kianfar M, Ershadi F S, Ahmadi Bani M. A Comparison of the Effects of Conventional Knee Ankle Foot Orthosis and TR-KAFO on Spasticity Parameters and Sleep Quality. Iranian Rehabilitation Journal 2025; 23 (2) :175-182
URL: http://irj.uswr.ac.ir/article-1-2028-fa.html

Objectives: A major problem faced by cerebral palsy children is spasticity. Spasticity is characterized by difficulty controlling, functioning, and coordinating movement of the body. Furthermore, it affects the quality of sleep of children. Orthosis plays a significant role in rehabilitation treatment for this condition, according to all treatments used. Orthosis, which have orthokinetic and neurologic properties, are used to reduce and control spasticity and hypertonicity by affecting muscle activity. The present study aims to evaluate the orthosis design for its efficacy in improving sleep quality and reducing spasticity. This study aims to assess the impact of a tone-reducing knee ankle foot orthosis (TR-KAFO) on sleep quality and spasticity in children with cerebral palsy.
Methods: This quasi-experimental study included patients with spastic cerebral palsy. 12 children ages 3 to 13 years with GMFcs 2 or 3 and modified Ashworth scores (1+ or 2) whose previous treatment has been conventional were identified from three occupational therapy clinics. We recruited 12 children already using conventional KAFO from three occupational therapy clinics for this study. The participants were randomly divided into two groups. The first group continued conventional treatment, while the second group transitioned to using the TR-KAFO for four weeks. Based on the type of KAFO used, participants were divided into two groups: TR-KAFO and conventional KAFO. The children were followed up for four weeks. At admission, spasticity was assessed with the modified Tardieu scale and sleep quality was assessed with the sleep disturbance scale for children (SDSC). We assessed the participants using the modified Tardieu scale and the SDSC at baseline and after 4 weeks to measure spasticity and sleep quality.
Results: Spasticity decreased, and sleep quality scores improved in TR-KAFO patients. The mean score of the children's sleep disorder scale in the TR-KAFO and normal KAFO groups was 45.67±6.377 and 53.17±5.037, respectively. A statistically significant difference was observed between the two groups (P<0.05).
Discussion: The results indicate that spasticity was significantly reduced in the group using the TR-KAFO. In addition, the data of the present study provided evidence that a tone-reducing orthosis during the night improved sleep quality in children with spastic cerebral palsy.