Determinants of demand for intelligent ankle-foot orthoses in children with cerebral palsy: a multicenter cross-sectional study from a multi-stakeholder perspective

Background Intelligent ankle-foot orthoses (AFOs) have emerged as a promising assistive technology for improving mobility in children with cerebral palsy (CP). However, their effective development and implementation require a comprehensive understanding of user needs from multiple stakeholders, particularly in resource-limited regions. Objective To systematically investigate the demand characteristics for intelligent AFOs among families of children with CP and medical professionals in Sichuan Province, and to identify key determinants influencing these demands. Methods A multicenter cross-sectional survey was conducted, including 95 families of children with CP and 39 medical professionals. Structured questionnaires were used to assess functional demands, usage experiences, and perceived barriers. Data were collected from multiple hospitals and rehabilitation centers across different administrative regions in Sichuan Province to enhance representativeness. Group differences were analyzed using non-parametric tests, and multivariate logistic regression was applied to identify independent determinants of demand. Results Families demonstrated the highest demand for practical and usability-oriented functions, particularly walking stability (93.69%) and ease of donning and doffing (83.16%). In contrast, medical professionals prioritized clinically oriented functions, including gait monitoring and predictive fall prevention (both 87.18%). Significant inter-group differences were observed in data monitoring ( p < 0.001) and adaptive adjustment ( p = 0.012). Multivariate analysis revealed that higher household income was significantly associated with increased demand for both data monitoring functions (OR = 3.13, 95% CI: 1.15–8.58, p = 0.026) and usability-related features (OR = 3.00, p = 0.033). Conclusion Demand for intelligent AFOs exhibits clear stakeholder-specific patterns, reflecting a divergence between practicality-driven needs among families and clinically oriented expectations among medical professionals. Safety, comfort, and indoor scenario adaptability represent shared priorities, while economic constraints and prior technology exposure further shape demand. These findings highlight the necessity of integrating multi-stakeholder perspectives into device design and support the development of context-specific strategies to improve accessibility and adoption in resource-limited settings.