Using the Edinburgh Visual Gait Score to Compare Ankle-Foot Orthoses, Sensorimotor Orthoses and Barefoot on Gait Pattern in Children with Cerebral Palsy: A Cross-Sectional Cohort Study

2019 ◽  
Author(s):  
Clare MacFarlane ◽  
Wayne Hing ◽  
Rob Orr
Keyword(s):  
Cerebral Palsy ◽  
Cohort Study ◽  
Gait Pattern ◽  
Foot Orthoses ◽  
Cross Sectional ◽  
Gait Quality ◽  
Ankle Foot Orthoses ◽  
Children With Cerebral Palsy ◽  
Gait Score ◽  
One Way Anova

Abstract Background: Gait analysis is one of the important aspects of evaluation in ambulatory children with cerebral palsy (CP). Typically prescribed for children with CP, ankle-foot orthoses (AFOs) improve gait and alignment through providing support and stability to the ankle complex. An alternative and under-researched orthosis being used in this population is the Sensomotoric orthotic (SMotO), which uses a different approach to correct alignment and improve gait. The Edinburgh Visual Gait Score (EVGS) is a valid, robust, reliable and easy-to-use observational gait analysis scale to measure of gait quality in CP. Improvements to gait could then be attributed to intervention, or regression of gait could be attributed to poor intervention or physical changes. Therefore, the aim of this study was to use the EVGS to determine the effect of SMotOs, AFOs and barefoot on gait pattern in children with CP. Methods: This cross-sectional cohort study investigated the differences in gait quality in children with CP between wearing SMotOs and AFOs through using the EVGS. Video imagery was taken when walking barefoot (where appropriate), in SMotOs and in AFOs for at least 5m at a self-directed pace. Individual scores and averages across the population were recorded. Data was analysed through SPSS statistics software (Version 20) and the Microsoft Office Excel 2007. A one-way ANOVA and post hoc Bonferroni were completed to identify significant differences with the alpha level set at p<.05. Results: One-way ANOVA analyses revealed significant differences between total left (p=0.011) and right (p=0.014) scores between SMotO and AFOs. Overall, results demonstrate improved gait in favour of SMotO vs AFO and that there are no significant differences between being barefoot and wearing AFOs. Conclusions: SMotOs are a viable orthotic option to improve gait in children with CP, but due to small yield of participants, a larger scale, blinded study should be performed to further determine results.

scholarly journals Using the Edinburgh Visual Gait Score to Compare Ankle-Foot Orthoses, Sensorimotor Orthoses and Barefoot Gait Pattern in Children with Cerebral Palsy

Children ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. 54 ◽  
Author(s):  
Clare MacFarlane ◽  
Wayne Hing ◽  
Robin Orr
Keyword(s):  
Cerebral Palsy ◽  
Gait Analysis ◽  
Gait Pattern ◽  
Spastic Diplegia ◽  
Foot Orthoses ◽  
Gait Quality ◽  
Spastic Quadriplegia ◽  
Ankle Foot Orthoses ◽  
Children With Cerebral Palsy ◽  
Gait Score

Gait analysis is one aspect of evaluation in ambulatory children with cerebral palsy (CP). Ankle-foot orthoses (AFOs) improve gait and alignment through providing support. An alternative and under-researched orthosis are sensomotoric orthoses (SMotOs). The Edinburgh Visual Gait Score (EVGS) is a valid observational gait analysis scale to measure gait quality. The aim of this study was to use the EVGS to determine what effect AFOs and SMotOs have on gait in children with CP. The inclusion criteria were: mobilizing children with a CP diagnosis, no surgery in the past six weeks, and currently using SMotOs and AFOs. Eleven participants were videoed walking 5 m (any order) barefoot, in SMotOs and AFOs. Of the participants (age range 3–13 years, mean 5.5 ± 2.9), two were female and six used assistive devices. Seven could walk barefoot. Participants had spastic diplegia (4), spastic quadriplegia (6), and spastic dystonic quadriplegia (1). Gross Motor Functional Classification System (GMFCS) levels ranged I–IV. The total score for SMotOs (7.62) and AFOs (14.18) demonstrated improved gait when wearing SMotOs (no significant differences between barefoot and AFOs). SMotOs may be a viable option to improve gait in this population. Additional study is required but SMotOs may be useful in clinical settings.

Improved motor function in a pre-ambulatory child with spastic bilateral cerebral palsy, using a custom rigid ankle-foot orthosis–footwear combination: A case report

2019 ◽  
Vol 43 (4) ◽  
pp. 453-458 ◽  
Author(s):  
Joshua Young ◽  
Sally Jackson
Keyword(s):  
Cerebral Palsy ◽  
Case Report ◽  
Gait Speed ◽  
Foot Orthoses ◽  
Ankle Foot Orthosis ◽  
Ankle Foot Orthoses ◽  
Children With Cerebral Palsy ◽  
Gait Score ◽  
The Subject ◽  
Foot Orthosis

Background: Ankle-foot orthoses may be used in pre-ambulatory children with cerebral palsy; however, their effect on the acquisition of walking is unknown. This case report aims to evaluate the effect of an ankle-foot orthosis–footwear combination on the acquisition of walking in a single subject with cerebral palsy. Case Description and Methods: This study reports the orthotic management of a single child with spastic bilateral cerebral palsy over a 15-month period, during which time the ability to independently stand and walk was acquired. Custom rigid ankle-foot orthoses were prescribed. Gait speed and Edinburgh Visual Gait Score were assessed with and without the orthoses. Findings and Outcomes: The subject developed the ability to stand and walk using an ankle-foot orthosis–footwear combination with a walker frame, and to a limited extent without a walker frame. The subject remained unable to take independent steps unless wearing the ankle-foot orthosis–footwear combination. Clinically significant differences in gait speed and Edinburgh Visual Gait Score were observed. Conclusion: An ankle-foot orthosis–footwear combination may aid the development of independent walking in some children with cerebral palsy. Further research on the effects of orthoses on the acquisition of walking ability in children with cerebral palsy is needed. Clinical relevance Custom rigid ankle-foot orthoses combined with footwear may aid the development of independent standing and walking in some children with bilateral spastic cerebral palsy. This intervention may be considered in clinical practice and future research in this patient group.

scholarly journals Sensomotoric Orthoses, Ankle–Foot Orthoses, and Children with Cerebral Palsy: The Bigger Picture

Children ◽  
2020 ◽  
Vol 7 (8) ◽  
pp. 82
Author(s):  
Clare MacFarlane ◽  
Robin Orr ◽  
Wayne Hing
Keyword(s):  
Quality Of Life ◽  
Cerebral Palsy ◽  
Well Being ◽  
Foot Orthoses ◽  
Timed Up And Go ◽  
Gross Motor ◽  
Ankle Foot Orthoses ◽  
Children With Cerebral Palsy ◽  
Gait Score

Ankle–foot orthoses (AFOs) and sensomotoric orthoses (SMotOs) are two—clinically relevant, yet under researched—types of lower limb orthoses used in children with cerebral palsy (CP). Quality of life is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Evaluating the effect of these two types of orthoses on quality of life in children with CP has not been reported on. The aim of this case study series was to synthesise and enrich the volume of evidence reported to inform real world applications of SMotO use in children with CP. Participants recruited were children with CP who performed the Berg Balance Scale, Timed Up-and-Go, the Gross Motor Function Measure and/or the Edinburgh Visual Gait Score in AFOs, SMotOs and barefoot where able. Qualitative data included videos of gait, a questionnaire and pedographs. Eight participants completed 39 quantitative and six qualitative measures, with the Edinburgh Visual Gait Score (EVGS) reporting the highest response. A general improvement was seen in gross motor skills and gait when wearing the SMotOs compared to AFOs and some parents reported that SMotOs were preferred. The reader is able to correlate the quantitative results with the qualitative evidence presented.

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

Ankle foot orthoses for young children with cerebral palsy: a scoping review

2019 ◽  
pp. 1-13 ◽  
Author(s):  
Pegah Firouzeh ◽  
Lyn K. Sonnenberg ◽  
Christopher Morris ◽  
Lesley Pritchard-Wiart
Keyword(s):  
Cerebral Palsy ◽  
Young Children ◽  
Scoping Review ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses ◽  
Children With Cerebral Palsy

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.

scholarly journals Effect of ankle-foot orthoses on gait in children with cerebral palsy: A meta-analysis

2016 ◽  
Vol 59 ◽  
pp. e6 ◽  
Author(s):  
Jean-Sébastien Bourseul ◽  
Mael Lintanf ◽  
Philippe Saliou ◽  
Sylvain Brochard ◽  
Christelle Pons
Keyword(s):  
Cerebral Palsy ◽  
Meta Analysis ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses ◽  
Children With Cerebral Palsy
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