Is there any relationship between orthotic usage and functional activities in children with neuromuscular disorders?

2013 ◽  
Vol 38 (1) ◽  
pp. 27-33 ◽  
Author(s):  
İpek Alemdaroğlu ◽  
Gozde Gür ◽  
Nilgün Bek ◽  
Öznur T Yılmaz ◽  
Yavuz Yakut ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Functional Performance ◽  
Neuromuscular Disorders ◽  
Neuromuscular Diseases ◽  
Foot Orthoses ◽  
Optimal Position ◽  
Functional Activities ◽  
Positive Effects ◽  
Ankle Foot Orthoses ◽  
Joint Range

Background: Contractures of Achilles tendons and gastrocnemius muscle deteriorate the performance in daily living activities of patients with neuromuscular diseases. Ankle–foot orthoses help to prevent the progression of deformities and to obtain optimal position of the joints to support standing and walking. Objective: To investigate the relationship between orthotic usage and functional activities in pediatric patients with different neuromuscular diseases. Study design: Retrospective study. Methods: A total of 127 subjects’ physical assessment forms were analyzed. Functional level, type of orthoses, falling frequencies, ankle joint range of motion, and timed performance tests were examined in two consecutive dates with an interval of 3 months. Results: A total of 91 patients were using orthoses while 36 patients were not within assessment dates. A total of 64 of 91 (70.3%) patients were diagnosed with Duchenne muscular dystrophy. A total of 81 (89.0%) subjects were using plastic ankle–foot orthoses for positioning at nights and 10 (11%) were using different types of the orthoses (knee–ankle–foot orthoses, dynamic ankle–foot orthoses, and so on) for gait in the study group. Conclusions: Night ankle–foot orthoses were not found to be effective directly on functional performance in children with neuromuscular diseases, although they protect ankle from contractures and may help to correct gait and balance. Clinical relevance This retrospective study shows that the positive effects of using an ankle–foot orthosis at night are not reflected in the functional performance of children with neuromuscular diseases. This may be due to the progressive deteriorating nature of the disease.

Effect of floor reaction ankle–foot orthosis on crouch gait in patients with cerebral palsy: What can be expected?

2017 ◽  
Vol 42 (3) ◽  
pp. 245-253 ◽  
Author(s):  
Harald Böhm ◽  
Hösl Matthias ◽  
Frank Braatz ◽  
Leonhard Döderlein
Keyword(s):  
Cerebral Palsy ◽  
Standard Deviation ◽  
Knee Extension ◽  
Spastic Cerebral Palsy ◽  
Foot Orthoses ◽  
Cross Sectional ◽  
Positive Effects ◽  
Foot Progression Angle ◽  
Ankle Foot Orthoses ◽  
Crouch Gait

Background: Floor reaction ankle–foot orthoses are commonly prescribed to improve knee extension of children with cerebral palsy having crouch gait. Their effectiveness is debated. Therefore, the objective of this study is to optimize current prescription criteria for the improvement of crouch gait. Study design: Cross-sectional interventional study. Methods: A total of 22 patients with bilateral spastic cerebral palsy, between 6 and 17 years, Gross Motor Function Classification System II–IV participated in this study. Instrumented gait analysis was done under three conditions: barefoot, shoed, and with orthotics. Patients were divided into two groups: good and non-responders with more and less than 8.8° improvement of knee extension during walking, respectively. A multiple predictor analysis was done on parameters that were different between groups. Results: In total, 12 of 22 patients showed good response in knee extension with a mean change of 17° (standard deviation = 5°). Good responders showed a significantly smaller walking velocity, knee extension strength, ankle plantarflexion strength, and greater external foot progression angle compared to non-responders. Foot progression angle together with ankle plantarflexion strength explained 37% of the variance in improvement of knee extension. Conclusion: With appropriate patient selection, an improvement of crouch gait by ankle–foot orthoses of 17° (standard deviation = 5°) can be expected. Patients with slow velocity, weak plantarflexors, and external foot progression benefit most. Joint contractures were no contraindications. Clinical relevance This study showed that gait in patients with low functional level benefit most from ankle–foot orthoses. Unlike in patients with higher functional status, contractures of hip, knee, and ankle did not reduce the positive effects on gait. The suggested prescription criteria may help to better select appropriate patients for orthotics.

The influence of ankle-foot orthoses on gait pathology in children with cerebral palsy: A retrospective study

2021 ◽  
Vol 90 ◽  
pp. 56-58
Author(s):  
L. Everaert ◽  
E. Papageorgiou ◽  
L. Beunnens ◽  
J. Van Collie ◽  
L. Labey ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Retrospective Study ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses ◽  
Children With Cerebral Palsy

scholarly journals Digital mapping of a manual fabrication method for paediatric ankle–foot orthoses

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Joyce Zhanzi Wang ◽  
Jonathon Lillia ◽  
Muhannad Farhan ◽  
Lei Bi ◽  
Jinman Kim ◽  
...  
Keyword(s):  
Euclidean Distance ◽  
Neuromuscular Disorders ◽  
Lower Leg ◽  
Medium Effect ◽  
Foot Orthoses ◽  
Digital Mapping ◽  
Modification Process ◽  
Ankle Foot Orthoses ◽  
Mean Differences ◽  
Plaster Casts

AbstractAnkle–foot orthoses (AFOs) are devices prescribed to improve mobility in people with neuromuscular disorders. Traditionally, AFOs are manually fabricated by an orthotist based on a plaster impression of the lower leg which is modified to correct for impairments. This study aimed to digitally analyse this manual modification process, an important first step in understanding the craftsmanship of AFO fabrication to inform the digital workflows (i.e. 3D scanning and 3D printing), as viable alternatives for AFO fabrication. Pre- and post-modified lower limb plaster casts of 50 children aged 1–18 years from a single orthotist were 3D scanned and registered. The Euclidean distance between the pre- and post-modified plaster casts was calculated, and relationships with participant characteristics (age, height, AFO type, and diagnosis) were analysed. Modification maps demonstrated that participant-specific modifications were combined with universally applied modifications on the cast's anterior and plantar surfaces. Positive differences (additions) ranged 2.12–3.81 mm, negative differences (subtractions) ranged 0.76–3.60 mm, with mean differences ranging from 1.37 to 3.12 mm. Height had a medium effect on plaster additions (rs = 0.35). We quantified the manual plaster modification process and demonstrated a reliable method to map and compare pre- and post-modified casts used to fabricate children's AFOs.

Ankle-foot orthoses for improving walking in people with calf muscle weakness due to neuromuscular disorders

2021 ◽  
Vol 2021 (9) ◽  
Author(s):  
Elza van Duijnhoven ◽  
Niels F Waterval ◽  
Fieke Sophia Koopman ◽  
Alberto Esquenazi ◽  
Sarah Tyson ◽  
...  
Keyword(s):  
Muscle Weakness ◽  
Neuromuscular Disorders ◽  
Calf Muscle ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses

scholarly journals Individual stiffness optimization of dorsal leaf spring ankle–foot orthoses in people with calf muscle weakness is superior to standard bodyweight-based recommendations

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Niels F. J. Waterval ◽  
Merel-Anne Brehm ◽  
Jaap Harlaar ◽  
Frans Nollet
Keyword(s):  
Muscle Weakness ◽  
Energy Cost ◽  
Activity Level ◽  
Calf Muscle ◽  
Leaf Spring ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses ◽  
The Individual ◽  
Optimal Stiffness ◽  
Walking Energy Cost

Abstract Background In people with calf muscle weakness, the stiffness of dorsal leaf spring ankle–foot orthoses (DLS-AFO) needs to be individualized to maximize its effect on walking. Orthotic suppliers may recommend a certain stiffness based on body weight and activity level. However, it is unknown whether these recommendations are sufficient to yield the optimal stiffness for the individual. Therefore, we assessed whether the stiffness following the supplier’s recommendation of the Carbon Ankle7 (CA7) dorsal leaf matched the experimentally optimized AFO stiffness. Methods Thirty-four persons with calf muscle weakness were included and provided a new DLS-AFO of which the stiffness could be varied by changing the CA7® (Ottobock, Duderstadt, Germany) dorsal leaf. For five different stiffness levels, including the supplier recommended stiffness, gait biomechanics, walking energy cost and speed were assessed. Based on these measures, the individual experimentally optimal AFO stiffness was selected. Results In only 8 of 34 (23%) participants, the supplier recommended stiffness matched the experimentally optimized AFO stiffness, the latter being on average 1.2 ± 1.3 Nm/degree more flexible. The DLS-AFO with an experimentally optimized stiffness resulted in a significantly lower walking energy cost (− 0.21 ± 0.26 J/kg/m, p < 0.001) and a higher speed (+ 0.02 m/s, p = 0.003). Additionally, a larger ankle range of motion (+ 1.3 ± 0.3 degrees, p < 0.001) and higher ankle power (+ 0.16 ± 0.04 W/kg, p < 0.001) were found with the experimentally optimized stiffness compared to the supplier recommended stiffness. Conclusions In people with calf muscle weakness, current supplier’s recommendations for the CA7 stiffness level result in the provision of DLS-AFOs that are too stiff and only achieve 80% of the reduction in energy cost achieved with an individual optimized stiffness. It is recommended to experimentally optimize the CA7 stiffness in people with calf muscle weakness in order to maximize treatment outcomes. Trial registration Nederlands Trial Register 5170. Registration date: May 7th 2015. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5170.

State of the Art Review of Knee–Ankle–Foot Orthoses

2015 ◽  
Vol 43 (2) ◽  
pp. 427-441 ◽  
Author(s):  
Feng Tian ◽  
Mohamed Samir Hefzy ◽  
Mohammad Elahinia
Keyword(s):  
State Of The Art ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses
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