Results of Orthoses Used on Ambulatory Patients With Bilateral Cerebral Palsy

Abstract

Objective: To investigate the impact of ankle-foot orthoses (AFO) on subjects diagnosed with bilateral cerebral palsy (CP) using the gait index and temporal data parameters. Methods: Twenty-four subjects, 14 male and 10 female, with a mean age of 11 (5-17 years old), underwent a comprehensive gait analysis under both barefoot (BF) and braced walking conditions. All children had been wearing the orthoses for at least 2 months before the gait analysis. Results: The overall values for the left and right Gait Profile Scores (GPS) did not show statistically significant variations when comparing the same individuals with and without orthoses. Gait velocity increased by 19.5% (p < 0.001), while the cadence decreased by 4% with use of orthosis, although it was not statistically significant (p > 0.05). The stride and the step lengths on both the right and left sides, however, resulted in statistically significant increases, when wearing AFO. Conclusion: AFO, prescribed for assistance by professionals without using gait data, did not significantly affect the gait index (GPS), but improved temporal data. The determination of quantitative clinical parameters for the prescription of orthotics in patients with bilateral CP, as well as orthotics that meet the specific requirements are points to be addressed in the future to obtain more significant effects. Level of evidence III, Case control study.

Exploring the rationale for prescribing ankle–foot orthoses and supramalleolar orthoses in children with cerebral palsy: A narrative synthesis of rationale statements

“…A large proportion (90%) of studies 7,19-21,25-27,30-64 describe that the rationale for prescribing AFOs to children with CP was to improve very discrete aspects of gait that would be measured in a gait laboratory (eg, normalize knee kinematics).“AFOs are a commonly prescribed medical device given to children with CP in an attempt to improve their gait” by manipulating “the ground reaction force and normalize gait kinetics and kinematics.” 54,p.5 “Rigid ventral ankle–foot orthoses are commonly prescribed in CP to improve knee extension during stance.” 20,p.68 …”

O Uso E a Confecção De Órteses Suropodálicas Feitas De Polipropileno Para Crianças Com Encefalopatia Crônica Não Evolutiva

“…Nesse sentido, as órteses ofertam esse alinhamento e consequente diminuição da espasticidade, possibilitando que a criança execute suas Atividades de Vida Diária, como o brincar, a educação, o descanso e sono, pois o paciente poderá exercer sua mobilidade, correr atrás dos objetos e ter um engajamento e desempenho ocupacional esperados para sua idade (Ireno et al, 2019;Roque et al, 2012;Melanda et al, 2020).…”

The Rehabilitation Interventions and Adaptive Technologies Used for Treating Patients With Cerebral Palsy

“…Orthotic management plays a significant role in treating patients with CP to provide them with efficient walking. Orthoses provide proper alignment to the joints and form an overhead rehabilitation intervention for patients with CP [ 35 ]. Orthopedic surgeries are also required to manage crouch gait; these include lengthening the hamstrings by Z-lengthening methods and fractional lengthening of this muscle [ 36 ].…”