scholarly journals An effect of spinal and ankle-foot orthoses on gait of spastic diplegic child: A case report

2021 ◽  
pp. 1-11
Author(s):  
Jurgita Ziziene ◽  
Kristina Daunoraviciene ◽  
Giedre Juskeniene ◽  
Jolanta Pauk
Keyword(s):  
Motor Dysfunction ◽  
Spastic Cerebral Palsy ◽  
Spastic Diplegia ◽  
Foot Orthoses ◽  
Knee Hyperextension ◽  
Study Results ◽  
Ankle Foot Orthoses ◽  
Spatiotemporal Parameters ◽  
The Difference ◽  
Spinal Orthosis

BACKGROUND: In children with spastic cerebral palsy (CP), the most common motor dysfunction is pathological gait. OBJECTIVE: To evaluate the effectiveness of measures for an individual CP case. METHODS: The case of one spastic diplegia child has been analyzed. Both lower extremities and spine were examined under three gait conditions: 1) barefoot, 2) with ankle-foot orthoses (AFOs) and thoracolumbosacral spinal orthosis (TLSO), and 3) with TLSO only. Spatiotemporal gait and kinematic parameters of the pelvic, hip, knee, ankle joints, and spine were obtained using Vicon Plug-in-Gait model. The difference (Δ) between the measured values and normative ranges was calculated to determine the efficiency of the orthoses. RESULTS: Significant differences were found in kinematic and spatiotemporal parameters comparing results between conditions and body sides. The effectiveness of the measures was confirmed by the smallest Δ values in the double and single support time with the AFOs/TLSO and in the stride and stance time with TLSO. CONCLUSIONS: Based on the study results, the best stability of the spine, ankle plantarflexion, and knee hyperextension is achieved with the AFOs/TLSO; therefore, this combination of measures was considered the most effective. However, not only quantitative parameters should be taken into account, but also the child’s willingness and comfort.

scholarly journals The effects of ankle-foot orthoses with plantar flexion stop and plantar flexion resistance using rocker-sole shoes on stroke gait: A randomized-controlled trial

2021 ◽  
Vol 67 (4) ◽  
pp. 449-461
Author(s):  
Aliyeh Daryabor ◽  
Gholamreza Aminian ◽  
Mokhtar Arazpour ◽  
Mina Baniasad ◽  
Sumiko Yamamoto
Keyword(s):  
Controlled Trial ◽  
Plantar Flexion ◽  
Three Dimensional ◽  
Chronic Phase ◽  
Controlled Study ◽  
Foot Orthoses ◽  
Randomized Controlled ◽  
Ankle Foot Orthoses ◽  
Spatiotemporal Parameters ◽  
Single Support Phase

Objectives: This study aims to evaluate the effect of two ankle-foot orthoses (AFOs), AFO with plantar flexion stop (AFO-PlfS), and AFO with plantar flexion resistance (AFO-PlfR), while wearing standard shoes and rocker-sole shoes. Patients and methods: Between November 2017 and July 2018, in this randomized-controlled study, a total of 20 stroke patients (8 males, 12 females; mean age: 48.1 years; range, 33 to 65 years) in chronic phase were randomized to AFO groups (AFO-PlfS group, n=10 and AFO-PlfR group, n=10). Each group received the allocated AFO along with two kinds of shoes (standard shoe and rocker shoe) for a two-week adaptation. Two effects were separately evaluated: The orthotic effect and rocker shoe effect were defined as the evaluation of using an AFO wearing standard shoe compared to only standard shoe, and evaluation of using an AFO wearing rocker shoe compared to an AFO wearing standard shoe, respectively. The gait of each group was measured by three-dimensional motion analysis. Results: A significant orthotic effect was found in both AFO groups in spatiotemporal parameters and maximum ankle dorsiflexion in the single-support phase. Additionally, the AFO-PlfR group showed a significant improvement in the parameters related to the first rocker of gait, but not for AFO-PlfS group concerning the orthotic effect. The rocker shoe effect was found in significant reduction of peak ankle plantar flexor moment and power ankle generation during preswing for both AFO groups. Conclusion: According to the orthotic effect, an AFO-PlfR can create better function in the improvement of parameters related to the first rocker. Although a rocker shoe can facilitate rollover for weight progression in the third rocker of gait, it cannot make a strong push-off function in stroke survivors.

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.

Effects of dynamic ankle-foot orthoses on standing in children with severe spastic diplegia

2005 ◽  
Vol 12 (5) ◽  
pp. 200-207 ◽  
Author(s):  
Annika Nslund ◽  
Kristina Jesinkey ◽  
Helga Hirschfeld ◽  
Lennart von Wendt ◽  
Gunnevi Sundelin
Keyword(s):  
Spastic Diplegia ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses

The effect of hinged ankle-foot orthoses on sit-to-stand transfer in children with spastic cerebral palsy

2004 ◽  
Vol 85 (12) ◽  
pp. 2053-2057 ◽  
Author(s):  
Eun Sook Park ◽  
Chang Il Park ◽  
Hyun Jung Chang ◽  
Jong Eun Choi ◽  
Don Shin Lee
Keyword(s):  
Cerebral Palsy ◽  
Spastic Cerebral Palsy ◽  
Foot Orthoses ◽  
Sit To Stand ◽  
Ankle Foot Orthoses

A three centre study of the variability of ankle foot orthoses due to fabrication and grade of polypropylene

2004 ◽  
Vol 28 (2) ◽  
pp. 175-182 ◽  
Author(s):  
P. Convery ◽  
R.J. Greig ◽  
R.S. Ross ◽  
S. Sockalingam
Keyword(s):  
Plantar Flexion ◽  
Bending Stiffness ◽  
Flexural Stiffness ◽  
Foot Orthoses ◽  
Centre Study ◽  
Significant Difference ◽  
Ankle Foot Orthoses ◽  
The Difference ◽  
Plaster Models

This study investigates if fabrication techniques employed at different orthotic centres affect the characteristics of the manufactured plastic orthoses.Plaster models were formed from the same master mould. The thickness and bending stiffness of the supplied polypropylene sheets were measured prior to fabrication.An orthotic technician at each of the 3 orthotic centres manufactured 4 homopolymer and 4 copolymer polypropylene ankle-foot orthoses (AFOs), following each centre's fabrication practice. Another technician at one of the orthotic centres manufactured an additional 4 homopolymer and 4 copolymer AFOs. The thickness, the dorsiflexion stiffness and plantar-flexion stiffness of the 32 fabricated AFOs were monitored and compared.Analysis of the results suggests: Copolymer polypropylene sheets are supplied marginally thicker than homopolymer polypropylene sheets The difference between the thickness of the 16 copolymer and 16 homopolymer AFOs was not significant. The thickness of the AFOs manufactured in copolymer was less consistent than homopolymer. Dorsiflexion stiffness of the copolymer AFOs was less consistent than homopolymer AFOs. Although the bending stiffness of the copolymer and homopolymer sheets differed significantly, there was no significant difference between the dorsiflexion stiffness of the copolymer and homopolymer AFOs. Plantarflexion stiffness was consistent for both the copolymer and the homopolymer AFOs and there was no significant difference between the plantarflexion stiffness of the copolymer and homopolymer AFOs. The thickness and flexural stiffness of the AFOs manufactured by 2 technicians at the same centre did not differ.These results are useful benchmarks for the flexural stiffness of AFOs.

scholarly journals The effect of community-prescribed ankle–foot orthoses on gait parameters in children with spastic cerebral palsy

2007 ◽  
Vol 1 (6) ◽  
pp. 325-332 ◽  
Author(s):  
Shlomo Hayek ◽  
Yoram Hemo ◽  
Sam Chamis ◽  
Reuven Bat ◽  
Eitan Segev ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Spastic Cerebral Palsy ◽  
Foot Orthoses ◽  
Gait Parameters ◽  
Ankle Foot Orthoses

scholarly journals Comparative trials on hybrid walking systems for people with paraplegia: An analysis of study methodology

1999 ◽  
Vol 23 (3) ◽  
pp. 260-273 ◽  
Author(s):  
M. J. Ijzerman ◽  
G. Baardman ◽  
H. J. Hermens ◽  
P. H. Veltink ◽  
H. B. K. Boom ◽  
...  
Keyword(s):  
Study Design ◽  
Statistical Power ◽  
Outcome Measurement ◽  
Interval Estimation ◽  
Interrupted Time Series ◽  
Foot Orthoses ◽  
User Friendliness ◽  
Ankle Foot Orthoses ◽  
The Difference ◽  
Comparative Trials

A new orthosis (SEPRIX) which combines user friendliness with low energy cost of walking has been developed and will be subject to a clinical comparison with conventional hip-knee-ankle-foot orthoses. In designing such comparative trials it was considered it may be worthwhile to use previous clinical studies as practical examples. A literature search was conducted in order to select all comparative trials which have studied two walking systems (hip-knee-ankle-foot orthoses) for patients with a complete thoracic lesion. Study population, intervention, study design, outcome measurement and statistical analyses were examined. Statistical power was calculated where possible. Of 12 selected studies, 7 were simple A-B comparisons, 2 A-B comparisons with a replication, 2 cross-over trials and 1 non-randomised parallel group design, the last of which was considered internally invalid due to severe confounding by indication. All A-B comparisons were considered internally invalid as well, since they have not taken into account that a comparison of two orthoses requires a control for aspecific effects (like test effects) which may cause a difference. Statistical power could only be examined in 4 studies and the highest statistical power achieved in one study was 47 %. It is concluded that statistical power was too low to be able to detect differences. Even analysis through interval estimation showed that the estimation of the difference was too imprecise to be useful. Since the majority of the surveyed papers have reported small studies (of only 4–6 patients), it is assumed that lack of statistical power is a more general problem. Three possibilities are discussed in order to enhance statistical power in comparative trials, i.e. multicentre studies, statistical pooling of results and improving the efficiency of study design by means of interrupted time series designs.

Ankle Foot Orthoses for Preambulatory Children with Spastic Diplegia

1996 ◽  
Vol 8 (4) ◽  
pp. 179
Author(s):  
Wilson. H ◽  
Haideri N ◽  
Song K ◽  
Telford D
Keyword(s):  
Spastic Diplegia ◽  
Foot Orthoses ◽  
Ankle Foot Orthoses

scholarly journals The effect of ankle–foot orthoses on self-reported balance confidence in persons with chronic poststroke hemiplegia

2013 ◽  
Vol 38 (2) ◽  
pp. 148-154 ◽  
Author(s):  
Angelika Zissimopoulos ◽  
Stefania Fatone ◽  
Steven Gard
Keyword(s):  
Study Design ◽  
Self Efficacy ◽  
Foot Orthoses ◽  
Ankle Foot Orthosis ◽  
Balance Confidence ◽  
Post Stroke ◽  
Study Results ◽  
Ankle Foot Orthoses ◽  
Foot Orthosis ◽  
Confidence Scale

Background: One intervention often used to address physical impairments post stroke is an ankle–foot orthosis. Ankle–foot orthoses may improve walking speed, stride length, and gait pattern. However, effects on balance, crucial for safe ambulation, are thus far inconclusive. One aspect of balance shown to contribute to functional ability is self-efficacy. Self-efficacy, defined as the belief in one’s ability to succeed in particular situations, has been shown to be more strongly associated with activity and participation (as defined by the International Classification of Functioning, Disability, and Health) than physical performance measures of gait or balance. Objectives: We investigated whether self-efficacy, or balance confidence when referred to in the context of balance capabilities, is improved with ankle–foot orthosis use. Study design: Repeated measures study design. Methods: Balance confidence was measured using the Activities-specific Balance Confidence Scale in 15 persons with chronic poststroke hemiplegia, with and without their regular ankle–foot orthosis. Results: Activities-specific Balance Confidence Scale scores were significantly higher ( p ≤ 0.01) for the ankle–foot orthosis condition compared to no ankle–foot orthosis. Conclusions: One mechanism by which ankle–foot orthosis use may influence balance is improved balance confidence. Future work should explore the specific mechanisms underlying this improvement in self-efficacy. Clinical relevance Self-efficacy may be an important factor to consider when evaluating functioning post stroke. Rehabilitative interventions that improve balance confidence may help restore participation and overall functioning in pathological populations, particularly in the fall-prone poststroke population. Study results provide evidence for improvements in balance confidence with ankle–foot orthosis use.

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