Long‐Term Effects of Orthoses Use on the Changes of Foot and Ankle Joint Motions of Children With Spastic Cerebral Palsy

Liu, Xuecheng; Embrey, David G.; Tassone, Channing; Zvara, Kim; Brandsma, Brenna A.; Lyon, Richard H.; Goodfriend, Karin; Tarima, Sergey; Thometz, John

doi:10.1016/j.pmrj.2017.08.438

Cited by 8 publications

(16 citation statements)

References 29 publications

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“…Abbreviations: CES-D, Center for Epidemiological Studies-Depression; FES-I, Fall Efficacy Scale-International; VAS, Visual Analog Scale; VPT, vibration perception threshold. 8,9,33 such as balance, fear of falling, and gait, but not on actual falls. The results of within-group comparison ( Table 2 and Figure 2) suggest that participants in the IG had lower fall rate and less proportion of fallers compared to the preceding year.…”

Section: Discussionmentioning

confidence: 99%

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Daily Use of Bilateral Custom‐Made Ankle‐Foot Orthoses for Fall Prevention in Older Adults: A Randomized Controlled Trial

Wang

Goel

Zhang

et al. 2019

J American Geriatrics Society

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OBJECTIVE To examine the effects of bilateral custom‐made ankle‐foot orthoses (AFOs) to prevent falls for older adults with concern about or at risk for falling over 12‐month daily use. DESIGN Secondary analysis of a randomized controlled trial. SETTING Community‐dwelling older adults. INTERVENTION Half of the participants were randomly allocated to an intervention group (IG) that received fitted walking shoes and bilateral custom‐made AFOs, and the other half were randomly allocated to a control group (CG) that only received fitted walking shoes. MEASUREMENTS Self‐reported fall history of 12‐month duration was investigated at baseline and 12‐month follow‐up for both groups. Fall incidence rate and proportion of fallers were used as outcome measures to determine effects of 12‐month footwear intervention in either group. PARTICIPANTS Adults aged 65 years and older with concern about or at risk for falling (n = 44). RESULTS No significant between‐group differences in participant characteristics were observed at the baseline (P = .144‐.882). Within the IG, significant reductions were found in the fall incidence rate (P = .039) and the proportion of fallers (P = .036) at the 12‐month follow‐up compared to the baseline. Within the CG, no significant change was found at the 12‐month follow‐up compared to the baseline for the fall incidence rate (P = .217) or the proportion of fallers (P = .757). When comparing the IG with the CG, there was no significant difference in the change from the baseline to the 12‐month follow‐up for the fall incidence rate (P = .572) or the proportion of fallers (P = .080). CONCLUSION This study failed to demonstrate a significant benefit of bilateral custom‐made AFOs to reduce falls compared to fitted walking shoes. However, the AFO users had significant reductions in falls compared to the preceding year. A future study with a larger sample size is recommended to confirm these observations. CLINICAL TRIAL REGISTRATION—URL: http://www.clinicaltrials.gov. Unique identifier: NCT02819011. J Am Geriatr Soc 67:1656–1661, 2019

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Section: Discussionmentioning

confidence: 99%

“…To our knowledge, this is the first RCT that directly assessed effects of daily use of bilateral custom‐made AFOs to reduce prospective falls in community‐dwelling older adults. A few previous studies investigated effects of AFOs on parameters related to fall risk, such as balance, fear of falling, and gait, but not on actual falls.…”

Section: Discussionmentioning

confidence: 99%

Daily Use of Bilateral Custom‐Made Ankle‐Foot Orthoses for Fall Prevention in Older Adults: A Randomized Controlled Trial

Wang

Goel

Zhang

et al. 2019

J American Geriatrics Society

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“…In addition, there are very few long-term studies in the literature regarding CP treatment. [30][31][32][33][34] Even current protocols, such as proposed by García-Galant et al fail to include a proper long-term assessment or follow-up. 35 Even regarding the use of invasive treatments, such as intrathecal Baclofen's or selective dorsal rhizotomy (SDR), that should actually had been better followed-up, the evidence is very scarce and insufficient.…”

Section: Discussionmentioning

confidence: 99%

Effect of Long-Term Repeated Interval Rehabilitation on the Gross Motor Function Measure in Children with Cerebral Palsy

et al. 2020

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Background The efficacy of interventions for cerebral palsy (CP) has been frequently investigated with inconclusive results and motor function measured by the Gross Motor Function Measure (GMFM-66) is common. Objective In this observational analysis, we quantify the GMFM-66 change scores of the second and third year of a multimodal rehabilitation program (interval rehabilitation including home-based, vibration-assisted training) in children with CP. Methods The study was a retrospective analysis of children with CP (2–13 years) participating for a second (n = 262) and third year (n = 86) in the rehabilitation program with GMFM-66 scores at start (M0), after 4 months (M4) of intensive training, and after 8 months of follow-up (M12). A method was previously developed to differentiate between possible treatment effects and expected development under standard of care for GMFM-66 scores using Cohen's d effect size (ES; size of difference). Results After the treatment phase of 4 months (M4) in the second year, 125 of 262 children were responder (ES ≥ 0.2) and 137 children nonresponder (ES < 0.2); mean ES for nonresponder was −0.212 (trivial) and for responder 0.836 (large). After M4 in the third year, 43 children of 86 were responder (ES = 0.881 [large]) and 43 nonresponder (ES = − 0.124 [trivial]). Discussion and Conclusion Repeated rehabilitation shows a large additional treatment effect to standard of care in 50% of children which is likely due to the intervention, because in the follow-up period (standard of care), no additional treatment effect was observed and the children followed their expected development.

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“…Additionally, there are significant differences in kinematic parameters of the hip, knee, and ankle joints, compared to healthy children [ 14 ]. For the purpose of the improvement of the dynamic gait efficiency, different types of AFO are recommended for patients with spastic hemiplegic CP [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Liu et al evaluated the changes of foot and ankle motion in long follow-up studies (18 months) in the group of 23 children with spastic CP (7 hemiplegic, 16 diplegic), during which patients were using solid ankle–foot orthoses (SAFOs), hinged ankle–foot orthoses (HAFOs), or supramalleolar orthoses (SMO). They observed that the long term use of AFOs can lead to maintaining or improving foot and ankle motion and function [ 15 ]. In our study, the step length was longer while the subjects were walking with AFO, comparing to walking barefoot, the gait speed has also improved significantly and the gait cadence was reduced.…”

Section: Discussionmentioning

confidence: 99%

The Utility of Gait Deviation Index (GDI) and Gait Variability Index (GVI) in Detecting Gait Changes in Spastic Hemiplegic Cerebral Palsy Children Using Ankle–Foot Orthoses (AFO)

et al. 2020

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Background: Cerebral palsy (CP) children present complex and heterogeneous motor disorders that cause gait deviations. Clinical gait analysis (CGA) is used to identify, understand and support the management of gait deviations in CP. Children with CP often use ankle–foot orthosis (AFO) to facilitate and optimize their walking ability. The aim of this study was to assess whether the gait deviation index (GDI) and the gait variability index (GVI) results can reflect the changes of spatio-temporal and kinematic gait parameters in spastic hemiplegic CP children wearing AFO. Method: The study group consisted of 37 CP children with hemiparesis. All had undergone a comprehensive, instrumented gait analysis while walking, both barefoot and with their AFO, during the same CGA session. Kinematic and spatio-temporal data were collected and GVI and GDI gait indexes were calculated. Results: Significant differences were found between the barefoot condition and the AFO conditions for selected spatio-temporal and kinematic gait parameters. Changes in GVI and GDI were also statistically significant. Conclusions: The use of AFO in hemiplegic CP children caused a statistically significant improvement in spatio-temporal and kinematic gait parameters. It was found that these changes were also reflected by GVI and GDI. These findings might suggest that gait indices, such as GDI and GVI, as clinical outcome measures, may reflect the effects of specific therapeutic interventions in CP children.

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Long‐Term Effects of Orthoses Use on the Changes of Foot and Ankle Joint Motions of Children With Spastic Cerebral Palsy

Abstract: Level II.

Cited by 8 publications

References 29 publications

Daily Use of Bilateral Custom‐Made Ankle‐Foot Orthoses for Fall Prevention in Older Adults: A Randomized Controlled Trial

Daily Use of Bilateral Custom‐Made Ankle‐Foot Orthoses for Fall Prevention in Older Adults: A Randomized Controlled Trial

Effect of Long-Term Repeated Interval Rehabilitation on the Gross Motor Function Measure in Children with Cerebral Palsy

The Utility of Gait Deviation Index (GDI) and Gait Variability Index (GVI) in Detecting Gait Changes in Spastic Hemiplegic Cerebral Palsy Children Using Ankle–Foot Orthoses (AFO)

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