Effects of Dynamic Elastomeric Fabric Orthoses on Children with Cerebral Palsy

Abstract

This phase 1 exploratory study aimed to establish proof of concept of the effects of dynamic elastomeric fabric orthoses (DEFOs) on the gait of children with spastic diplegic cerebral palsy. Replicated single case experiments employing an ABA methodology were carried out on eight subjects (median age 5.5 years, range 3-13 years; 4 girls/boys) utilizing quantitative/qualitative data collection. Outcome measures were: Ten metre walking test (10MWT); physiological cost index (PCI); visual analogue scale (VAS) scoring of perceived gait changes; functional mobility changes using Patient Specific Functional Scale (PSFS); subject/carer perceptions recorded in daily diaries. Results identified following analysis of quantitative data indicated a treatment effect from the orthoses which could be corroborated by participant subjective impressions and comments. Statistically significant (p < 0.05) intervention-related improvements in gait velocity and gait consistency were identified respectively in 5/8 and 4/8 subjects. Power calculations support the feasibility of a larger controlled study to further investigate this orthotic intervention. This study indicates that DEFO leggings can confer beneficial effects on the gait of some children with spastic diplegia resulting from CP. These findings have implications for orthotic intervention with this subject group.

Efficacy of suit therapy on functioning in children and adolescents with cerebral palsy: a systematic review and meta‐analysis

“…12 In recent decades, different biomedical, surgical, and biomechanical innovations have led to the development of new intervention techniques 11 in the (re)habilitation of young people with CP, namely therapeutic garments with a roughly similar construction and intention of Adeli suit 13 such as dynamic movement orthoses or lycra body suit orthoses. 14 The designs of these orthoses range from full body suits to smaller garments such as sleeves/gloves and leggings.…”

Effect of Dynamic Elastomeric Fabric Orthoses on Postural Control in Children With Cerebral Palsy

“…The orthosis supports the pelvic girdle by means of elastic band and provides a knee extension moment, which contributes to abduction of the hips and derotation of the lower limbs. 22,27,28 Only a few studies have been reported in which the researchers objectively investigated the effect of DEFOs in children with CP. Matthews et al 22 Lycra garments did not improve pelvic, hip, knee, and ankle joint stability in children with neurodisability.…”

“…[24][25][26] Dynamic elastomeric fabric orthoses are made of neoprene and consist of elastic pants, which are full leggings extending from the iliac crest to below the malleoli 22 and zippering on the lateral side of each lower extremity ( Figure 1). The orthosis supports the pelvic girdle by means of elastic band and provides a knee extension moment, which contributes to abduction of the hips and derotation of the lower limbs.…”

“…Although dynamic elastomeric fabric orthoses cost almost the same as rigid AFOs, they may be more preferable for children with CP. 22 Since soft orthoses do not encompass the foot and ankle joint like AFOs, they could be used with different types of shoes. This gives the child and his or her family the opportunity to select the desired shoes, which can positively affect the overall acceptance of the orthosis and the rehabilitation procedure.…”

“…After the DEFOs were received, each child wore them for 6 weeks approximately 4 to 6 hours per day. 10,22,28 Children with TD received no intervention.…”