The influence of the use of ankle-foot orthoses on thorax, spine, and pelvis kinematics during walking in children with cerebral palsy

2017 ◽  
Vol 42 (2) ◽  
pp. 208-213 ◽  
Author(s):  
Eva Swinnen ◽  
Jean-Pierre Baeyens ◽  
Benjamin Van Mulders ◽  
Julian Verspecht ◽  
Marc Degelaen
Keyword(s):  
Cerebral Palsy ◽  
Postural Control ◽  
Range Of Motion ◽  
Motor Function ◽  
Classification System ◽  
Spastic Cerebral Palsy ◽  
Foot Orthoses ◽  
Lateral Bending ◽  
Ankle Foot Orthoses ◽  
Children With Cerebral Palsy

Background:To improve gait function in children with cerebral palsy, ankle-foot orthoses are often prescribed. However, until now, little attention has been devoted to the effect of ankle-foot orthoses on the postural control during walking in children with cerebral palsy.Objectives:The aim was to compare the differences in thorax, spine, and pelvis movements in children with cerebral palsy during walking barefoot and walking with ankle-foot orthoses.Study design:Clinical study with an intra subject design.Methods:A total of 15 children (12 boys and 3 girls; mean age, 8 ± 2 years) with bilateral spastic cerebral palsy (12 with Gross Motor Function Classification System I and 3 with Gross Motor Function Classification System II) performed a full-body three-dimensional gait analysis. Differences in the range of motion of the thorax, spine, and pelvis during walking barefoot and walking with bilateral ankle-foot orthoses were analyzed (SPSS v20, paired-samples t-test).Results:Children with cerebral palsy showed a significantly larger range of motion of the thorax (flexion/extension, lateral bending, and rotation) and the spine (lateral bending) during walking with ankle-foot orthoses compared to walking barefoot. No significant differences were found in the range of motion of the pelvis between these two conditions.Conclusion:It can be concluded that wearing ankle-foot orthoses influences the postural control during walking in children with bilateral spastic cerebral palsy. Due to the increased range of motions, the movement pattern of the trunk diverges from the typically developing children.Clinical relevanceWearing ankle-foot orthoses not only gives more stability at the pelvis and ankle joint but also influences trunk motion. In order of the level of core stability of the child, compensations can be either seen in the lower back or the upper trunk. Clinicians should be aware of these compensations and should evaluate postural control in a more detailed evaluation.

Effect of ankle-foot orthoses on gait, balance and gross motor function in children with cerebral palsy: a systematic review and meta-analysis

2018 ◽  
Vol 32 (9) ◽  
pp. 1175-1188 ◽  
Author(s):  
Mael Lintanf ◽  
Jean-Sébastien Bourseul ◽  
Laetitia Houx ◽  
Mathieu Lempereur ◽  
Sylvain Brochard ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Activities Of Daily Living ◽  
Motor Function ◽  
Daily Living ◽  
Spastic Cerebral Palsy ◽  
Foot Orthoses ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Ankle Foot Orthoses ◽  
Children With Cerebral Palsy

Objective: To determine the effects of ankle-foot orthoses (AFOs) on gait, balance, gross motor function and activities of daily living in children with cerebral palsy. Data sources: Five databases were searched (Pubmed, Psycinfo, Web of Science, Academic Search Premier and Cochrane Library) before January 2018. Review methods: Studies of the effect of AFOs on gait, balance, gross motor function and activities of daily living in children with cerebral palsy were included. Articles with a modified PEDRO score ≥ 5/9 were selected. Data regarding population, AFO, interventions and outcomes were extracted. When possible, standardized mean differences (SMDs) were calculated from the outcomes. Results: Thirty-two articles, corresponding to 56 studies (884 children) were included. Fifty-one studies included children with spastic cerebral palsy. AFOs increased stride length (SMD = 0.88, P < 0.001) and gait speed (SMD = 0.28, P < 0.001), and decreased cadence (SMD = –0.72, P < 0.001). Gross motor function scores improved (Gross Motor Function Measure (GMFM) D (SMD = 0.30, P = 0.004), E (SMD = 0.28, P = 0.02), Pediatric Evaluation of Disability Inventory (PEDI) (SMD = 0.57, P < 0.001)). Data relating to balance and activities of daily living were insufficient to conclude. Posterior AFOs (solid, hinged, supra-malleolar, dynamic) increased ankle dorsiflexion at initial contact (SMD = 1.65, P < 0.001) and during swing (SMD = 1.34, P < 0.001), and decreased ankle power generation in stance (SMD = –0.72, P < 0.001) in children with equinus gait. Conclusion: In children with spastic cerebral palsy, there is strong evidence that AFOs induce small improvements in gait speed and moderate evidence that AFOs have a small to moderate effect on gross motor function. In children with equinus gait, there is strong evidence that posterior AFOs induce large changes in distal kinematics.

scholarly journals Gastrocnemius operating length with ankle foot orthoses in cerebral palsy

2016 ◽  
Vol 41 (3) ◽  
pp. 274-285 ◽  
Author(s):  
Hwan Choi ◽  
Tishya Anne Leong Wren ◽  
Katherine Muterspaugh Steele
Keyword(s):  
Cerebral Palsy ◽  
Classification System ◽  
Daily Life ◽  
System Level ◽  
Foot Orthoses ◽  
Functional Classification ◽  
Ankle Foot Orthosis ◽  
Ankle Foot Orthoses ◽  
Children With Cerebral Palsy ◽  
Foot Orthosis

Background:Many individuals with cerebral palsy wear ankle foot orthoses during daily life. Orthoses influence joint motion, but how they impact muscle remains unclear. In particular, the gastrocnemius is commonly stiff in cerebral palsy. Understanding whether orthoses stretch or shorten this muscle during daily life may inform orthosis design and rehabilitation.Objectives:This study investigated the impact of different ankle foot orthoses on gastrocnemius operating length during walking in children with cerebral palsy.Study design:Case series, within subject comparison of gastrocnemius operating length while walking barefoot and with two types of ankle foot orthoses.Methods:We performed gait analyses for 11 children with cerebral palsy. Each child was fit with two types of orthoses: a dynamic ankle foot orthosis (Cascade dynamic ankle foot orthosis) and an adjustable dynamic response ankle foot orthosis (Ultraflex ankle foot orthosis). Musculoskeletal modeling was used to quantify gastrocnemius musculotendon operating length and velocity with each orthosis.Results:Walking with ankle foot orthoses could stretch the gastrocnemius more than barefoot walking for some individuals; however, there was significant variability between participants and orthoses. At least one type of orthosis stretched the gastrocnemius during walking for 4/6 and 3/5 of the Gross Motor Functional Classification System Level I and III participants, respectively. AFOs also reduced peak gastrocnemius lengthening velocity compared to barefoot walking for some participants, with greater reductions among the Gross Motor Functional Classification System Level III participants. Changes in gastrocnemius operating length and lengthening velocity were related to changes in ankle and knee kinematics during gait.Conclusion:Ankle foot orthoses impact gastrocnemius operating length during walking and, with proper design, may assist with stretching tight muscles in daily life.Clinical relevanceDetermining whether ankle foot orthoses stretch tight muscles can inform future orthotic design and potentially provide a platform for integrating therapy into daily life. However, stretching tight muscles must be balanced with other goals of orthoses such as improving gait and preventing bone deformities.

Ankle-foot orthoses: effect on gait in children with cerebral palsy

2002 ◽  
Vol 24 (7) ◽  
pp. 345-347 ◽  
Author(s):  
Erbil Dursun ◽  
Nigar Dursun ◽  
Duygu Alican
Keyword(s):  
Cerebral Palsy ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses ◽  
Children With Cerebral Palsy

scholarly journals GROSS MOTOR FUNCTION CLASSIFICATION SYSTEM (GMFCS) FOR CHILDREN WITH CEREBRAL PALSY

2019 ◽  
Vol 7 (7) ◽  
pp. 3281-3286
Author(s):  
Mst. Rabea Begum ◽  
◽  
Mohammad Anwar Hossain ◽  
Shahnaj Sultana ◽  
◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Classification System ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Children With Cerebral Palsy

scholarly journals Effectiveness of Virtual Reality and Visual Feedback on Balance and Leg Function in Children with Cerebral Palsy

2019 ◽  
Vol 1 (18) ◽  
Author(s):  
Arūnė Dūdaitė ◽  
Vilma Juodžbalienė
Keyword(s):  
Virtual Reality ◽  
Cerebral Palsy ◽  
Postural Control ◽  
Range Of Motion ◽  
Visual Feedback ◽  
Lower Limb ◽  
Dynamic Balance ◽  
Control Group ◽  
Children With Cerebral Palsy ◽  
Stretching Exercises

Research background. Virtual reality and visual feedback improve motor performance, motor function and balance, so we want to fnd if it affects the function of legs and balance of children with spastic hemiplegia. Research aim was to establish if the use of virtual reality and visual feedback with traditional physiotherapy improve the function of legs and balance of children with cerebral palsy. Methods. Nine children with cerebral palsy participated in the research. Participants were randomly divided into two groups – virtual reality group (n = 6) and control (n = 3). Virtual reality group practised exergaming and stretching exercises for 10 weeks, twice a week. Control group practiced conventional physiotherapy and stretching exercises for 6 weeks, twice a week. We measured the range of motion of the lower limb, spasticity of the lower limb using Modifed Ashworth’o Scale, static, dynamic balance, trunk coordination using Trunk Impairment Scale at the start and the end of the research, and balance using Pediatric Balance Scale. Results. Virtual reality and visual feedback reduced the spasticity of the lower limb, improved balance and postural control for children with cerebral palsy, but it did not improve the range of motion of the lower limb of children with cerebral palsy. Conclusions. Virtual reality and visual feedback did not improve the range of motion of the lower limb of children with cerebral palsy. Virtual reality and visual feedback reduced spasticity of the lower limb, improved balance and postural control for children with cerebral palsy.Keywords. Cerebral palsy, virtual reality, visual feedback, postural control, muscle architecture.

A DYNAMIC SEATING SYSTEM FOR CHILDREN WITH CEREBRAL PALSY

2009 ◽  
Vol 12 (01) ◽  
pp. 21-30 ◽  
Author(s):  
Michael E. Hahn ◽  
Sheri L. Simkins ◽  
Jacob K. Gardner ◽  
Gaurav Kaushik
Keyword(s):  
Cerebral Palsy ◽  
Range Of Motion ◽  
Motor Function ◽  
Control Group ◽  
Significant Group ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Muscle Spasticity ◽  
Children With Cerebral Palsy ◽  
Dynamic Seating

The study's aim was to determine the initial effects of a dynamic seating system as a therapeutic intervention in children with cerebral palsy. A two-factor, repeated-measures design was used. Twelve children with neuromuscular dysfunction (mean age 6.0, SD 2.7 years) were included in the study, randomly assigned to an experimental or a control group. At study initiation the experimental group received a wheelchair with dynamic seating components that allows limited range of motion in the hip and knee, and the control group received a static setting wheelchair. Participants were evaluated for range of motion, muscle spasticity (Modified Ashworth Scale), motor function (Gross Motor Function Measure), and level of disability (Pediatric Evaluation of Disability Inventory) at study initiation, 3-months, and 6-months post intervention. Both groups improved in motor function over time, particularly in the categories of Sitting and Crawl/Kneel. Measures of disability improved in both groups for the categories of self-care, mobility, and social function. A larger, more homogeneous sample would likely show significant group differences in measures of muscle spasticity, gross motor function and disability.

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