Acclimatization of the gait pattern to wearing an ankle–foot orthosis in children with spastic cerebral palsy

Kerkum, Yvette L.; Brehm, Merel-Anne; Hutten, Kim van; Noort, Josien C. van den; Harlaar, Jaap; Becher, Jules G.; Buizer, Annemieke I.

doi:10.1016/j.clinbiomech.2015.03.023

Cited by 17 publications

(23 citation statements)

References 31 publications

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“…Our findings showed that the majority of studies introduced a costume made AFO build by an orthotist [1,8,13,19] in cooperation with a physical therapy, [1,8,13,19] although information about its composition and material was scarce [3,4,7,17].…”

Section: Resultsmentioning

confidence: 79%

“…All the studies have analyzed spatiotemporal parameters, with the more recurrent parameters being step length (m), stride length (m), cadence (steps/minute) and walking speed (m/min) [1,4,16,12,18,20,21]. Some parameters like step time, single and double support time, stance and swing time were also present in a few studies [3,8,18]. In respect to kinematic and kinetic data, only two studies [4,18] didn't investigate one of these parameters.…”

Section: Information Relating the Afo Interventionmentioning

confidence: 99%

“…The kinetic data was very restricted in the studies with only one third, [3,7,8,17] of the studies investigating this parameter, like the hip, knee and the ankle moment (Nm/kg) [1,8,17]. In the other hand kinematic analysis was often considered, like the knee flexion and extension angle (º) [3,8,17,19] and also the dorsiflexion ROM of the ankle [8,12,[19][20][21]. Nevertheless some studies also considered others outcomes, like functional outcomes related to daily activity and participation of the children, like Children's Assessment of Participation and Enjoyment (CAPE), [4,13,12] physical examination by physical therapist [4,16,17,12,21] and even outcomes related to the AFOs satisfaction [4,13,12] and others more specific measures related to the specific aim of the studies, summarized in "other parameters" at table II and table III. 3.7.…”

Section: Information Relating the Afo Interventionmentioning

confidence: 99%

“…Spasticity, muscle weakness and decreased selective motor control, often cause limitations in mobility and activities of day living like walking. These limitations, which limit patient's ability to walk [1,3], impact families and -without proper adaptations -may lead to restricted participation in daily life, affecting social relations and education [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…It is suggested that this system is a commonly intervention in children with CP, and can improve joint stability, posture, and gait skills [6,7]. Therefore, studies have shown that to improve gait and reduce walking limitations, children with CP might use ankle foot orthoses (AFOs) [1,3,4,6,7]. Some studies on the literature evaluating the effects of AFOs on gait in children with CP generally report improvement in gait parameters, like spatiotemporal parameters, joint kinematics and kinetics, and knee extension [3,6].…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical Outcomes Related with Gait in Children with Cerebral Palsy Using Ankle-Foot Orthotic - A Systematic Review

Gordo

Pascoal‐Faria

Mateus

et al. 2019

AMM

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Gait in children with cerebral palsy (CP) is often affected by motor impairments which limit the patient's ability to walk. To improve gait and reduce walking limitations, children with CP need to use ankle foot orthoses. An orthosis is an externally applied device that is designed and fitted to the body to achieve one or more of the following goals: a) Control biomechanical alignment. b) Correct or accommodate deformity, and 3) Protect and support an injury. This systematic review aims to describe research evidence supporting the use of ankle-foot orthoses to improve gait biomechanical outcomes among individuals with CP. Literature search was pursued from PubMed database. Studies were included if (1) they evaluated an outcome measure related with gait using ankle-foot orthotic (AFO) in children (2) considered children with a diagnosis of CP and have a (3) GMFCS classification of I, II or III. Papers were excluded if they evaluated (1) other population besides CP, (2) the use of orthoses other than AFOs and (3) gait analysis procedure was not presented. All the included studies have analyzed spatiotemporal parameters, the step length (m), stride length (m) and cadence (steps/minute) were the most frequently reported. Our findings showed that several studies have investigated the effects of AFOs, all of which have reported positive influences on at least one gait parameter, as well as positive changes in joint kinematics and kinetic in children with CP.

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Section: Resultsmentioning

confidence: 79%

Section: Information Relating the Afo Interventionmentioning

confidence: 99%

Section: Information Relating the Afo Interventionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Biomechanical Outcomes Related with Gait in Children with Cerebral Palsy Using Ankle-Foot Orthotic - A Systematic Review

Gordo

Pascoal‐Faria

Mateus

et al. 2019

AMM

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Ankle foot orthoses in cerebral palsy: Effects of ankle stiffness on trunk kinematics, gait stability and energy cost of walking

Meyns

Kerkum

Brehm

et al. 2020

European Journal of Paediatric Neurology

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In children with cerebral palsy (CP), rigid ventral shell ankle-foot orthoses (vAFOs) are often prescribed to reduce excessive knee flexion in stance and lower the energy cost of walking (ECW). However, how vAFOs affect ECW is a complex issue, as vAFOs may have an impact on lower limb biomechanics, upper body movements, and balance. Besides, the vAFO's biomechanical effect have been shown to be dependent on its stiffness around the ankle joint. We examined whether vAFO stiffness influences trunk movements and gait stability in CP, and whether there is a relationship between these factors and ECW. Fifteen children with spastic CP were prescribed vAFOs. Stiffness was varied into a rigid, stiff and flexible configuration. At baseline (shoes-only) and for each vAFO stiffness configuration, 3D-gait analyses and ECW-tests were performed. From the gait analyses, we derived trunk tilt, lateroflexion, and rotation range of motion (RoM) and the mediolateral and anteroposterior Margins of Stability (MoS) and their variability as measures of gait stability. With the ECW-test we determined the netEC. We found that wearing vAFOs significantly increased trunk lateroflexion (Wald c2 ¼ 33.7, p < 0.001), rotation RoM (Wald c2 ¼ 20.5, p < 0.001) and mediolateral gait instability (Wald c2 ¼ 10.4, p ¼ 0.016). The extent of these effects partly depended on the stiffness of the vAFO. Significant relations between trunk movements, gait stability and ECW were found r ¼ 0.57e0.81, p < 0.05), which indicates that trunk movements and gait stability should be taken into account when prescribing vAFOs to improve gait in children with CP walking with excessive knee flexion.

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An individual approach for optimizing ankle-foot orthoses to improve mobility in children with spastic cerebral palsy walking with excessive knee flexion

et al. 2016

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Acclimatization of the gait pattern to wearing an ankle–foot orthosis in children with spastic cerebral palsy

Cited by 17 publications

References 31 publications

Biomechanical Outcomes Related with Gait in Children with Cerebral Palsy Using Ankle-Foot Orthotic - A Systematic Review

Biomechanical Outcomes Related with Gait in Children with Cerebral Palsy Using Ankle-Foot Orthotic - A Systematic Review

Ankle foot orthoses in cerebral palsy: Effects of ankle stiffness on trunk kinematics, gait stability and energy cost of walking

An individual approach for optimizing ankle-foot orthoses to improve mobility in children with spastic cerebral palsy walking with excessive knee flexion

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