DOI QR코드

DOI QR Code

Immediate Effect of Fabric Ankle-Foot Orthosis on Spatiotemporal Gait Parameters in Children With Spastic Cerebral Palsy

패브릭 발목 보조기가 경직성 뇌성마비 아동의 시공간적 보행 변수에 미치는 즉각적인 효과

  • Sim, Yon-Ju (Dept. of Physical Therapy, The Graduate School, Yonsei University) ;
  • Lee, Dong-Ryul (Sports and Fitness Center for Children With Disabilities, Yonsei University) ;
  • Yi, Chung-Hwi (Dept. of Physical Therapy, College of Health Science, Yonsei University)
  • 심연주 (연세대학교 대학원 물리치료학과) ;
  • 이동률 (연세대학교 장애아동 체력증진실) ;
  • 이충휘 (연세대학교 보건과학대학 물리치료학과)
  • Received : 2014.01.02
  • Accepted : 2014.02.11
  • Published : 2014.02.19

Abstract

The purpose of this study was to investigate the immediate effect of fabric ankle-foot orthosis on spatiotemporal gait parameters, compared to a barefoot condition in children with spastic cerebral palsy. Eleven children with spastic cerebral palsy participated in this study. Spatiotemporal gait parameters were measured with the GAITRite system. Fabric ankle-foot orthosis significantly improved Timed Up and Go test time and gait velocity. There was no significant difference in cadence. The step time significantly improved in both the more and less affected foot compared to the barefoot condition. The step length of the affected foot also significantly improved, but there was no significant difference in the step length of the less affected foot. There was significant improvement in the stride length of both the affected and less affected foot, but no significant difference in single stance or double stance. The fabric ankle-foot orthosis could improve stability, and selective control of the joint and promote better walking in children with cerebral palsy. Consequently, the fabric ankle-foot orthosis might be an alternative assistive device for neurological populations as a primary role instead of the typical ankle-foot orthosis.

References

  1. Abel MF, Juhl GA, Vaughan CL, et al. Gait assessment of fixed ankle-foot orthoses in children with spastic diplegia. Arch Phys Med Rehabil. 1998;79(2):126-133. https://doi.org/10.1016/S0003-9993(98)90288-X
  2. Andersson C, Grooten W, Hellsten M, et al. Adults with cerebral palsy: Walking ability after progressive strength training. Dev Med Child Neurol. 2003;45(4):220-228.
  3. Benard MR, Harlaar J, Becher JG, et al. Effects of growth on geometry of gastrocnemius muscle in children: A three-dimensional ultrasound analysis. J Anat. 2011;219(3):388-402. https://doi.org/10.1111/j.1469-7580.2011.01402.x
  4. Baddar A, Granata K, Damiano DL, et al. Ankle and knee coupling in patients with spastic diplegia: Effects of gastrocnemius-soleus lengthening. J Bone Joint Surg Am. 2002;84(5):736-744. https://doi.org/10.2106/00004623-200205000-00006
  5. Balaban B, Yasar E, Dal U, et al. The effect of hinged ankle-foot orthosis on gait and energy expenditure in spastic hemiplegic cerebral palsy. Disabil Rehabil. 2007;29(2):139-144. https://doi.org/10.1080/17483100600876740
  6. Banks HH, Green WT. The correction of equinus deformity in cerebral palsy. J Bone Joint Surg Am. 1958;40(6):1359-1379. https://doi.org/10.2106/00004623-195840060-00013
  7. Boulay C, Pomero V, Viehweger E, et al. Dynamic equinus with hindfoot valgus in children with hemiplegia. Gait Posture. 2012;36(1):108-112. https://doi.org/10.1016/j.gaitpost.2012.01.015
  8. Buckon CE, Thomas SS, Jakobson-Huston S, et al. Comparison of three ankle-foot orthosis configurations for children with spastic diplegia. Dev Med Child Neurol. 2004;46(9):590-598.
  9. Buckon CE, Thomas SS, Jakobson-Huston S, et al. Comparison of three ankle-foot orthosis configurations for children with spastic hemiplegia. Dev Med Child Neurol. 2001;43(6):371-378. https://doi.org/10.1017/S0012162201000706
  10. Carlson WE, Vaughan CL, Damiano DL, et al. Orthotic management of gait in spastic diplegia. Am J Phys Med Rehabil. 1997;76(3):219-225. https://doi.org/10.1097/00002060-199705000-00012
  11. Chung CY, Ahn CH, Choi IH, et al. Kinematic and kinetic changes of the ankle after the correction of spastic equinus deformity: Z-plastic lengthening versus strayer method. J Korean Orthop Assoc. 2002;37(6):759-765. https://doi.org/10.4055/jkoa.2002.37.6.759
  12. Cobeljic G, Bumbasirevic M, Lesic A, et al. The management of spastic equinus in cerebral palsy. Orthop Trauma. 2009;23(3):201-209. https://doi.org/10.1016/j.mporth.2009.05.003
  13. Condie DN, Meadows CB. Ankle-Foot Orthoses: Biomechanical basis of orthotic management. Oxford, England, Butterworth-Heineman, 1993: 99-123.
  14. Damiano DL, Prosser LA, Curatalo LA, et al. Muscle plasticity and ankle control after repetitive use of a functional electrical stimulation device for foot drop in cerebral palsy. Neurorehabil Neural Repair. 2013;27(3):200-207. https://doi.org/10.1177/1545968312461716
  15. de Saca LR, Catlin PA, Segal RL. Immediate effects of the toe spreader on the tonic toe flexion reflex. Phys Ther. 1994;74(6):561-570. https://doi.org/10.1093/ptj/74.6.561
  16. Duncan WR. Tonic reflexes of the foot. Their orthopaedic significance in normal children and in children with cerebral palsy. J Bone Joint Surg Am. 1960;42-A:859-868.
  17. Dusing SC, Thorpe DE. A normative sample of temporal and spatial gait parameters in children using the GAITRite electronic walkway. Gait Posture. 2007;25(1):135-139. https://doi.org/10.1016/j.gaitpost.2006.06.003
  18. Gage JR, Deluca PA, Renshaw TS. Gait analysis: Principles and applications. Emphasis on its use in cerebral palsy. J Bone Joint Surg Am. 1995;77(10):1607-1623. https://doi.org/10.2106/00004623-199510000-00017
  19. Goldstein M, Harper DC. Management of cerebral palsy: Equinus gait. Dev Med Child Neurol. 2001;43(8):563-569. https://doi.org/10.1017/S0012162201001025
  20. Graham HK, Aoki KR, Autti-RamoI, et al. Recommendations for the use of botulinum toxin type a in the management of cerebral palsy. Gait Posture. 2000;11(1):67-79. https://doi.org/10.1016/S0966-6362(99)00054-5
  21. Graham HK, Fixsen JA. Lengthening of the calcaneal tendon in spastic hemiplegia by the white slide technique. A long-term review. J Bone Joint Surg Br. 1988;70(3):472-475.
  22. Graham HK, Selber P. Musculoskeletal aspects of cerebral palsy. J Bone Joint Surg B. 2003; 85(2):157-166. https://doi.org/10.1302/0301-620X.85B2.14066
  23. Hwang YI, An DH, Yoo WG. Effects of the dual afo on gait parameters in stroke patients. NeuroRehabilitation. 2012;31(4):387-393.
  24. Katz-Leurer M, Rotem H, Lewitus H, et al. Functional balance tests for children with traumatic brain injury: Within-session reliability. Pediatr Phys Ther. 2008;20(3):254-258. https://doi.org/10.1097/PEP.0b013e3181820dd8
  25. Kim HJ, Chun MH, Kim HM, et al. Effects on foot external rotation of the modified ankle-foot orthosis on post-stroke hemiparetic gait. Ann Rehabil Med. 2013;37(4):516-522. https://doi.org/10.5535/arm.2013.37.4.516
  26. Kim SG, Ryu YU, Kim WH. The effectiveness of backward gait training on the treadmill in children with spastic diplegic cerebral palsy: A pilot study. Phys Ther Kor. 2012;19(3):81-90. https://doi.org/10.12674/ptk.2012.19.3.081
  27. Klotz MC, Wolf SI, Heizmann D, et al. The influence of botulinum toxin a injections into the calf muscles on genu recurvatum in children with cerebral palsy. Clin Orthop Relat Res. 2013; 471(7):2327-2332. https://doi.org/10.1007/s11999-013-2897-7
  28. Lowes LP, Habib Z, Bleakney D, et al. Relationship between clinical measures of balance and functional abilities in children with cerebral palsy. Pediatr Phys Ther. 1996;8(4):176.
  29. Molnar GE, Alexander MA. Pediatric Rehabilitation. 3rd ed. Philadelphia, PA, Hanley & Belfus, 1999:193-217.
  30. O'Connell PA, D'Souza L, Dudeney S, et al. Foot deformities in children with cerebral palsy. J Pediatr Orthop. 1998;18(6):743-747.
  31. Perry J, Davids JR. Gait analysis: Normal and pathological function. J Pediatr Orthop. 1992;12 (6):815.
  32. Sees JP, Miller F. Overview of foot deformity management in children with cerebral palsy. J Child Orthop. 2013;7(5):373-377. https://doi.org/10.1007/s11832-013-0509-4
  33. Simkin A, Robin GC, Magora A, et al. Investigation of gait. 6. Relationship between muscle action and mechanical stresses in below-knee braces. Electromyogr Clin Neurophysiol. 1973;13(5): 495-503.
  34. Sorsdahl AB, Moe-Nilssen R, Strand LI. Test-retest reliability of spatial and temporal gait parameters in children with cerebral palsy as measured by an electronic walkway. Gait Posture. 2008;27(1):43-50. https://doi.org/10.1016/j.gaitpost.2007.01.001
  35. Stein RB, Chong S, Everaert DG, et al. A multicenter trial of a footdrop stimulator controlled by a tilt sensor. Neurorehabil Neural Repair. 2006;20(3):371-379. https://doi.org/10.1177/1545968306289292
  36. Strayer LM Jr. Recession of the gastrocnemius; An operation to relieve spastic contracture of the calf muscles. J Bone Joint Surg Am. 1950;32(3):671-676. https://doi.org/10.2106/00004623-195032030-00022
  37. Sutherland DH, Kaufman KR, Wyatt MP, et al. Double-blind study of botulinum a toxin injections into the gastrocnemius muscle in patients with cerebral palsy. Gait Posture. 1999;10(1):1-9.
  38. Tachdjian MO. The Child's Foot. Philadelphia, PA, W.B. Saunders Co., 1985:556-597.
  39. White H, Jenkins J, Neace WP, et al. Clinically prescribed orthoses demonstrate an increase in velocity of gait in children with cerebral palsy: A retrospective study. Dev Med Child Neurol. 2002;44(4):227-232. https://doi.org/10.1017/S0012162201001992
  40. Williams EN, Carroll SG, Reddihough DS, et al. Investigation of the timed 'up & go' test in children. Dev Med Child Neurol. 2005;47(8): 518-524. https://doi.org/10.1017/S0012162205001027