Orthotic management of cerebral palsy

doi:10.1111/j.1469-8749.2007.00791.x

Cited by 7 publications

(1 citation statement)

References 53 publications

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“… 33 However, the origin of this brace started with an explanation of the concept and it was used in clinical practice without clear study. 34 , 35 However, in previous studies, the hip abduction brace combined with botulinum toxin injection was shown to be ineffective in preventing hip displacement. 15 , 16 , 19 These results may be attributed to the inclusion of patients with lower risk of displacement (GMFCS levels I-III), the selection of incidence of surgery as the primary outcome, ineffectiveness of the previous abduction brace, and botulinum toxin injection to hamstring rather than the hip adductors muscles.…”

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confidence: 99%

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

et al. 2022

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ImportanceThere is no consensus on interventions to slow the progress of hip displacement in patients with cerebral palsy.ObjectiveTo investigate the efficacy of a novel hip brace in preventing progressive hip displacement in patients with cerebral palsy.Design, Setting, and ParticipantsThis 2-group randomized clinical trial was conducted at 4 tertiary hospitals in South Korea from July 2019 to November 2021. Participants included children aged 1 to 10 years with nonambulatory cerebral palsy (Gross Motor Function Classification System level IV or V). Block randomization was used to assign an equal number of patients to the study and control groups via computerized random allocation sequences. Data were analyzed from November to December 2021.InterventionsThe intervention group wore the hip brace for at least 12 hours a day for the study duration (ie, 12 months). Follow-up evaluations were performed after 6 and 12 months of wearing the brace. Both groups proceeded with conventional rehabilitation therapy during the trial.Main Outcomes and MeasuresThe primary outcome was the Reimers migration index (MI) on radiography, as assessed by 3 blinded investigators. Primary outcome variables were analyzed using linear mixed models. Secondary outcomes include change in the Caregiver Priorities &amp; Child Health Index of Life with Disabilities, on which lower scores indicate better quality of life.ResultsA total of 66 patients were included, with 33 patients (mean [SD] age, 68.7 [31.6] months; 25 [75.8%] boys) randomized to the intervention group and 33 patients (mean [SD] age, 60.7 [24.9] months; 20 [60.6%] boys) randomized to the control group. The baseline mean (SD) MI was 37.4% (19.3%) in the intervention group and 30.6% (16.3%) in the control group. The mean difference of the MI between the intervention group and control group was −8.7 (95% CI, −10.2 to −7.1) percentage points at 6 months and −12.7 (95% CI, −14.7 to −10.7) percentage points at 12 months. The changes in the Caregiver Priorities &amp; Child Health Index of Life with Disabilities were favorable in the study group and reached statistical significance at the 6-month follow-up compared with the control group (difference, −14.2; 95% CI, −25.2 to −3.3).Conclusions and RelevanceIn this randomized clinical trial, the novel hip brace was significantly effective in preventing the progression of hip displacement, compared with the control group. It effectively improved quality of life in patients with nonambulatory cerebral palsy. Therefore, hip brace use could be a promising treatment method to delay hip surgery and improve the quality of life of patients with nonambulatory cerebral palsy.Trial RegistrationClinicalTrials.gov Identifier: NCT04033289

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