Summary from the academy's seventh state-of-the-science conference on knee-ankle-foot orthoses for ambulation

This article summarizes the results from deliberations by an international multidisciplinary group of experts convened by the American Academy of Orthotists and Prosthetists to review the State-of-the-Science regarding use of custom-made knee-ankle-foot orthoses (KAFOs) to assist in ambulation. Based on a comprehensive review of peer-reviewed literature from the past decade, only four articles on this topic were identified as controlled trials, with only three investigating the use of KAFOs by clinical populations. The participants concluded that there is currently no substantive evidence at the highest level of scientific certainty regarding the use of KAFOs and hip-knee-ankle-foot orthoses (HKAFOs) for ambulation, but there are a number of core assumptions supported by expert opinion and peer-reviewed publications that can be considered clinical hypotheses about these orthoses. These rehabilitation beliefs can and should be tested in future research applications. Six primary research priorities and associated implications were identified. The panelists concluded that scientific research into these questions would significantly advance our understanding about the optimal application of KAFOs and HKAFOs to assist in ambulation.