Effect of ankle-foot orthoses on gait, balance and gross motor function in children with cerebral palsy: a systematic review and meta-analysis

Lintanf, Mael; Bourseul, Jean-Sébastien; Houx, Laëtitia; Lempereur, Mathieu; Brochard, Sylvain; Pons, Christelle

doi:10.1177/0269215518771824

Cited by 47 publications

(47 citation statements)

References 56 publications

(367 reference statements)

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“…The reported changes that reach statistical significance were also clinically meaningful (gait velocity and stride length). As walking velocity is often used as a surrogate measure for overall gait quality, we can say that orthoses in our sample produced functional benefits, agreeing with a systematic review and meta-analysis published by Lintanf et al, 27 despite avoiding the appearance of musculoskeletal deformities. Furthermore, we can observe the results above point to an improvement in function, since the increase in velocity relates to an increase in the stride length, rather than an increase in cadence, as shown in Table 3.…”

Section: Discussionsupporting

confidence: 90%

Results of Orthoses Used on Ambulatory Patients With Bilateral Cerebral Palsy

Melanda

Pauleto²,

Iucksch

et al. 2020

Acta ortop. bras.

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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.

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Section: Discussionsupporting

confidence: 90%

Results of Orthoses Used on Ambulatory Patients With Bilateral Cerebral Palsy

Melanda

Pauleto²,

Iucksch

et al. 2020

Acta ortop. bras.

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“…The use of SPIO helped in improving posture, which is the basis of movement [11]. AFO and SMO have positively influenced standing and walking, which is in line with findings in an earlier study [12].…”

Section: Discussionsupporting

confidence: 89%

Xia-Gibbs Syndrome: A Rare Case Report of a Male Child and Insight into Physiotherapy Management

Goyal

Naqvi

Sahu

2020

Cureus

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Xia-Gibbs syndrome (XGS) is a recently discovered genetic disorder. It is characterized by global developmental delay, intellectual impairment, hypotonia, and sleep abnormalities. While the current literature emphasizes on the genotype and phenotype of this rare condition, it does not provide any description of the physiotherapy management of patients with XGS. We report a case of a 27-month-old Indian male diagnosed with XGS, who presented with difficulty in sitting without support. He had dysmorphic facies, hypotonia, hyperextensible joints, mild kyphoscoliosis, and global developmental delay. His parents and an elder female sibling were clinically asymptomatic. The physiotherapy intervention was based on the principles of neurodevelopmental treatment (NDT) and sensory integration (SI). The management included facilitation of transitions, weight-bearing exercises, wheelbarrow walking, joint compressions, rib cage mobilization, multidirectional reaching, and pushing-pulling activities along with the use of equipment like Swiss ball, balance board, stability disc, trampoline, swing system, walker (rollator), and walking harness. Also, stabilizing pressure input orthosis (SPIO) for the trunk and ankle-foot orthosis (AFO) followed by supramalleolar orthosis (SMO) were used for support. Thereafter, the child was able to stand and walk without support at the age of 36 months, and walk on uneven terrain at the age of 42 months. In addition, he could negotiate stairs using handrails with mild assistance. His gross motor function measure-88 (GMFM-88) total score improved from 21% at the presentation to 66.6% following the treatment. It was observed that the NDT and SI approaches along with the use of appropriate orthoses accelerated the achievement of motor milestones in this case. To the best of our knowledge, this is the first case report of a child with XGS that emphasizes on the course of physiotherapy management for the associated motor delay.

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“…In this context, tridimensional (3D) printed devices allows a more accurate biomechanical analysis of the disadvantages of these devices, through the manufacture of more specific models for each patient, with personalized and functional design. Therefore, improvement of gait pattern is an important goal in treatment of children with CP, due to its impact on autonomy and participation of these children in society [2]. Thus, the present pilot study objective is to verify whether there is a difference between conventional polypropylene AFO and 3D printing AFO, with and without ankle external propulsion system, in pelvis kinematics during the gait of children with CP.…”

Section: Introductionmentioning

confidence: 95%

“…Ankle foot orthosis (AFO) plays an important role in treatment of patients with neuromuscular impairments, such as cerebral palsy (CP) [1]. The AFOs are prescribed aiming the prevention and/or correction of foot deformities, function improvement, ankle efficiency and performance, facilitating functional activities, such as gait, of children with CP [2,3]. Therefore, the non-use of AFOs by patients with CP can deteriorate their gait and joints range of motion [4].…”

Section: Introductionmentioning

confidence: 99%

3D printing orthosis with propulsion system increases pelvic rotation in gait of children with cerebral palsy

Lana¹,

Aquino²,

Horta³

et al. 2020

Proceedings of the 6th World Congress on New Technologies

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INTRODUCTION: Despite the short-and long-term benefits, the continuous use of orthotics causes impairments due to movement restriction, such as disuse atrophy of ankle plantar flexor muscles. Consequently, an inefficient push-off might be present, generating kinematic compensations in distant regions of the ankle (e.g. pelvis), due to force transmission thru interactions of the body kinetic chain. Thus, the objective of present pilot study is to verify whether there is a difference between conventional polypropylene ankle foot orthosis (AFO) and tridimensional (3D) printing AFO with and without ankle external propulsion system, in pelvis kinematics during the gait of children with cerebral palsy (CP). METHODS: This pilot study investigated the plegic lower limb kinematic data, during self-selected walking speed, of five children with hemiplegic CP (5 to 17 years old) were collected with a 3D motion analysis system. One-way ANOVA repeated measures was used to compared pelvis frontal and transverse plane amplitudes in two hinged AFO on three conditionsconventional, 3D printing with and without propulsion system. RESULTS: Pelvis amplitude in transverse plane showed differences between conditions (p = 0,04), indicating that AFO with propulsion system increases pelvic rotation during gait. That is, more energy might reach pelvis coming from the ankle, through 3D printing AFO with propulsion system, increasing pelvis transverse plane movement, and facilitating the swing of the contralateral limb forward. Pelvis frontal plane amplitude was not significant (p = 0,16). CONCLUSION: Gait analysis demonstrated differences in the transverse plane amplitude of the pelvis, when comparing the three AFO conditions. The assistance of a propulsion system simulating the action of the triceps sural muscle might be able to increase pelvic rotation in the transverse plane, positively impacting gait pattern. Pelvic rotation may influence other gait parameters such as step length and symmetry between limbs, which should be investigated in the future.

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Effect of ankle-foot orthoses on gait, balance and gross motor function in children with cerebral palsy: a systematic review and meta-analysis

Cited by 47 publications

References 56 publications

Results of Orthoses Used on Ambulatory Patients With Bilateral Cerebral Palsy

Results of Orthoses Used on Ambulatory Patients With Bilateral Cerebral Palsy

Xia-Gibbs Syndrome: A Rare Case Report of a Male Child and Insight into Physiotherapy Management

3D printing orthosis with propulsion system increases pelvic rotation in gait of children with cerebral palsy

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