Assessment of gait characteristics and orthotic management in children with Developmental Coordination Disorder: preliminary findings to inform multidisciplinary care.
Foot orthoses alone did not meaningfully change gait in kids with DCD—target muscle activation first.
01Research in Context
What this study did
The team gave foot orthoses to 14 children with Developmental Coordination Disorder. They measured gait before and after the inserts.
Kids wore the orthoses either at the start or the end of a rehab program. The goal was to see if the inserts alone made walking smoother.
What they found
Cadence and double-support time improved slightly, but the changes were not significant. In plain words, the inserts did not clearly fix the clumsy walk.
The authors call the results “non-significant trends” and warn against using orthoses as a stand-alone fix.
How this fits with other research
Fujiura et al. (2018) looked at the same population and found weaker gastrocnemius and hamstring firing at heel strike. Their data help explain why Peters et al. (2013) saw little benefit from inserts alone—if the muscles are not activating, a plastic wedge under the heel cannot do the work.
Amore et al. (2011) and Adams et al. (2024) show that kids with DCD skip after-school games and struggle in school. These participation papers line up with the gait work: poor mechanics lead to less movement, which leads to even weaker muscles.
Murphy et al. (2014) gave us a quick parent checklist, the DCDDaily-Q, that picks up the same daily-life slips the gait lab measures. Taken together, the four papers argue for a package deal—strength training, activity coaching, and only then orthotics if still needed.
Why it matters
Do not rush to order custom inserts when a new DCD referral lands on your desk. Screen leg-muscle activation first, add phased strengthening, and use parent reports to track real-world change. Save orthoses for the few kids who still need extra support after the muscles wake up.
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02At a glance
03Original abstract
Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder characterised by impaired motor co-ordination and awkward gait. Despite self-reported findings of pes planus and joint hypermobility in children with DCD, there is little objective evidence regarding the clinical management of the foot in children with DCD. The aims of this research were to report clinical findings of foot posture and lower limb hypermobility in children with DCD and to evaluate the impact of foot orthoses on spatio-temporal gait parameters. Children with DCD were recruited into the study. Participants were randomly assigned to an intervention group who received foot orthoses at the start of their rehabilitation programme or to a second group who received foot orthoses at the end of their intervention programme. Foot posture was assessed with the Foot Posture Index and lower limb hypermobility assessed with the Lower Limb Assessment Score. The effect of foot orthoses was evaluated through assessment of spatio-temporal gait characteristics at baseline and post-rehabilitation programme. Fourteen children were recruited (mdn age 7.5 years) with nine children assigned to the group receiving orthoses early (mdn age 8 years) and five children assigned to the post-rehabilitation orthoses group (mdn age 6.5 years). A pes planus foot posture (FPI score=8) and lower limb hypermobility (LLAS score=11) were observed. Changes in spatio-temporal gait parameters failed to reach significance (p>.012) following orthotic invention but demonstrated a trend towards a decreased cadence and increased double support duration. Despite non-significant findings this work offers preliminary support for podiatric intervention in the rehabilitation of children with DCD. Further work is required to understand the biomechanics of gait in children with DCD and appreciate the role of podiatry as a component of multidisciplinary care.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.06.012