Ankle and foot orthoses have been used frequently to help children with cerebral palsy gait patterns. The use of ankle and foot orthoses helps improve foot alignment, helps with balance, and prevents deformity (331). When wearing ankle-foot orthoses, they help prevent tiptoe walking, decrease the activity of the gastrocnemius and prevent equinus because they block plantar flexion beyond ninety degrees (331). There are three case studies of three children with cerebral palsy. These case studies explain how children compensate when they are unable to perform a heel lift due to blocked forefoot swing and blocked toe movements. There are three-foot movements in the gait: heel swing, ankle swing and forefoot swing. barbell. Heel swing begins when the foot makes initial contact or heel strike with the ground and ends with the foot flat. This is where the ankle is typically in ninety degrees of plantar flexion and is the motion that is typically blocked by AFOs (331). The ankle rocker is the second movement of the gait pattern. It is when the foot is completely in contact with the ground and ends with the heel off. Then the forefoot rocker begins, which is the third foot movement in the gait pattern. The forefoot rocker begins with the heel off and continues until the foot lifts off the ground. At this point, during gait, the toes begin to extend approximately fifty-five degrees before the foot leaves the ground (331). Extending the toes during gait helps allow the body to move forward over the foot. Therefore, if forefoot swing is blocked during gait, the child may not be able to move forward. The child may compensate by shortening the length of the foot or by inverting or everting the foot (332). There are... half of the document... the motor function classification system. Examination of case studies shows that making small changes to the trim lines of foot orthoses can make a huge difference in the gait pattern of a child with cerebral palsy. Since orthoses have not been described in detail, it is very difficult to compare the above-mentioned studies. When doing research it is essential to evaluate all foot and ankle orthoses, even if the focus is only on gait. Since a child spends most of their time with a physical therapist, it is the physical therapist's responsibility to communicate with the doctor or orthotist about any concerns or problems the child may have with orthoses during gait. Works Cited Carmick, Judy PT MA. Forefoot mobility in ankle and foot orthoses: Effects on gait of children with cerebral palsy. Pediatric physical therapy. 2013; 25:331-337