Effects of an underwear-type hip abduction orthosis on sitting balance and sit-to-stand activities in children with spastic cerebral palsy

Abstract

[Purpose] Hip dislocation and subluxation are common in patients with cerebral palsy (CP). Hip abduction orthoses are used to prevent and treat these problems. This study investigated the effects of an underwear-type hip abduction orthosis on sitting balance and sit-to-stand (STS) activity in children with spastic CP. [Participants and Methods] This trial had a cross-over design. Eight children aged 6 to 18 years old with spastic CP and Gross Motor Function Classification level III and IV were randomly allocated to groups with or without use of the underwear-type hip orthosis. The trunk impairment scale (TIS) score was evaluated and the 5-times sit-to-stand test (FTSST) was conducted with and without the underwear. [Results] The dynamic sitting balance scores in the TIS and FTSST showed significant improvement with use of the orthotic underwear. [Conclusion] The dynamic sitting balance scores of the TIS and FTSST were higher, thus indicating better stability, when wearing the orthosis underwear. Thus, it was suggested that underwear-type hip abduction orthoses are effective for promoting sitting balance and STS activities in children with spastic CP.

Efficacy of a Hip Brace for Hip Displacement in Children With Cerebral Palsy

“…Meanwhile, several studies regarding nonsurgical treatment for hip displacement, including various types of hip abduction braces, postural alignment seating systems, and botulinum toxin injection, have reported inconsistent results . In previous research, we showed that a seating system with medial knee support could act as a fulcrum, thereby accelerating progressive hip displacement in patients with nonambulatory spastic cerebral palsy .…”

“…Meanwhile, several studies regarding nonsurgical treatment for hip displacement, including various types of hip abduction braces, postural alignment seating systems, and botulinum toxin injection, have reported inconsistent results. 15 , 16 , 17 , 18 , 19 , 20 In previous research, we showed that a seating system with medial knee support could act as a fulcrum, thereby accelerating progressive hip displacement in patients with nonambulatory spastic cerebral palsy. 21 In a follow-up study, the electromyographic activity of adductor muscles was significantly decreased after introducing a dynamic hip compression bandage, suggesting potential benefits.…”

‘What if it were like this?’ Perception of mothers of children with cerebral palsy about the ankle‐foot orthosis of their children: A qualitative study

“…Children with cerebral palsy (CP) have musculoskeletal impairments, which are often associated with comorbidities such as cognitive disorders, which directly interfere in acquiring essential motor skills to perform daily activities and participating in the environment in which they live (Ahmadi, O'Neil, Fragala‐Pinkham, Lennon, & Trost, 2018; Graham, Paget, & Wimalasundera, 2019). Spastic CP is the most common clinical form (85%) (Novak, 2011; Zanini, Cemin, & Peralles, 2009), which presents a higher risk of developing secondary complications (Jeffries, Fiss, McCoy, & Bartlett, 2016; Kusumoto et al, 2018) such as foot deformities due to the alteration in tonus, with equinus being among the most frequently observed (Kedem & Scher, 2015; Miller, 2018). Biomechanical foot misalignments are regularly addressed through a recommendation of orthoses, with the ankle‐foot orthosis (AFO) preferably being prescribed (Miller, 2018).…”