Clinically prescribed orthoses demonstrate an increase in velocity of gait in children with cerebral palsy: a retrospective study

Abstract

The purpose of this study was to determine the effect clinically prescribed ankle-foot orthoses (AFOs) have on the temporal-spatial parameters of gait, as compared with barefoot walking in children with cerebral palsy. A retrospective chart review of data collected between 1995 and 1999 in our motion analysis laboratory was performed. A retrospective chart review of 700 patients revealed 115 patients (mean age 9 years) who had a primary diagnosis of CP (diplegia n=97, hemiplegia n=18). All were wearing clinically prescribed hinged or solid AFOs at the time of undergoing a three dimensional gait analysis. In line with our standard clinical practice, data for both conditions (braced and barefoot walking) were collected the same day by the same examiner. Statistical analyses indicated the temporal and spatial gait parameters of velocity, stride length, step length, and single limb stance were significantly increased (p<0.001) with the use of AFOs versus barefoot walking. Cadence was the only parameter found to not be statistically different.

Evaluating interventions to improve gait in cerebral palsy: a meta‐analysis of spatiotemporal measures

“…When comparing quantitative results of the studies in the meta-analysis, two studies were found to be distinctly different to the others. One of these studies 62 had an effect size that did not appear to be consistent with the other studies. This study was a retrospective study involving 115 patients, the largest sample size of any study in this meta-analysis.…”

Orthopedic equipment applied in children with cerebral palsy

“…ankle-foot orthosis), a wybór najodpowiedniejszej uzależniony jest od wieku dziecka, nasilenia przykurczy mięśniowych, jak i od stopnia dysfunkcji stawów i towarzyszących zniekształ-ceń stóp. Doniesienia naukowe oparte na nielicznych grupach chorych z mpd, dotyczące używania przez nich AFO, wskazują na korzyści płynące z ich stosowania w aspekcie biomechanicznym (na podstawie analizy trójprzestrzennej chodu), energetycznym (ocenionym za pomocą spirometrii i kalorymetrii), a przede wszystkim funkcjonalnym (wyrażo-nym poprawą wzorca chodu i postawy) [35][36][37][38][39][40][41][42].…”

“…W trójwymiarowej, czasowo-przestrzennej analizie, porównując chód dzieci z mpd w ortezach stabilizujących staw skokowy i boso, stwierdzano poprawę takich parametrów, jak szybkość, długość kroku oraz zakres zgięcia grzbietowego stopy [35,36]. Przekłada się to na sprawniejsze przemieszczanie się przy użyciu tego zaopatrzenia ortopedycznego.…”

“…Scientifi c reports based on few groups of patients with ICP concerning the usage of AFO indicate the benefi ts taking into account biomechanical aspect (based on three--dimensional analysis of the gait), energetic aspect (evaluated by means of spirometry and calorimetry) and most of all functional aspect (expressed by the gait and posture patterns) [35][36][37][38][39][40][41][42].…”

Efeitos do uso de órtese na mobilidade funcional de crianças com paralisia cerebral

“…Considerados os pré-requisitos para inclusão no estudo, os critérios para indicação de órtese rígida foram: limitação da amplitude normal do movimento de dorsoflexão do tornozelo, medida durante a avaliação goniométrica e necessidade de reforço muscular para maior estabilidade da pelve e tronco durante a postura de pé. A indicação da órtese articulada levou em conta os seguintes critérios: ausência de restrições da amplitude de movimento de dorsoflexão do tornozelo, medida durante avaliação goniométrica 20 . Após a entrega dos dispositivos, as crianças tiveram um período de 15 dias para adaptação às novas órteses.…”