Working in a center for children with neuromuscular diseases I see twice a year a boy (15) suffering from Morbus Duchenne. Is is not able to walk nor any weightbearing on his feet. His feet tend to go into plantarflexion/suppination contractures- as in any other patient with M. Duchenne. State of the art of treatment is to make them wear ankle-foot-orthoses, but there is no evidence for less problems or pain. This boy really feels unconfortable to wear those orthoses. They reduces his qualitiy of life- so he says.
So what shell I recommend? Nowing his reduces life expectancy, thinking that QOL are highest values to achieve and doubting about effects of the orthoses I would recommend not to wear the orthoses. But treatmentprocedures tell me something else and how knows if he will not suffering from pain in his feet in a few years?