Influence of orthopaedic-technical aid on the kinematics and kinetics of the knee joint of patients with neuro-orthopaedic diseases

Lampe, Renée; Mitternacht, Jürgen; Schrödl, Silvia; Gerdesmeyer, Ludger; Natrath, Michaela; Gradinger, R.

doi:10.1016/s0387-7604(03)00129-3

Cited by 17 publications

(9 citation statements)

References 2 publications

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“…However, midstance was not significantly affected. These results are in agreement with some previous studies [17][18][19], while on the other hand Buckon et al [20] recently concluded that AFO use did not markedly alter joint kinematics in children with spastic hemiplegia. We demonstrated that the use of AFOs in spastic hemiplegic children improved gait symmetry mainly in time parameters such as double support time, thus minimizing limp and body sway.…”

Section: Discussionsupporting

confidence: 92%

The effect of community-prescribed ankle–foot orthoses on gait parameters in children with spastic cerebral palsy

Hayek

Hemo

Chamis

et al. 2007

Journal of Children's Orthopaedics

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Purpose To evaluate the efficacy of ankle foot orthoses (AFOs) prescribed in the community for children with cerebral palsy (CP). Methods Fifty-six children (32 boys and 24 girls, mean age 8.9 years, range 4-17) who were diagnosed as having CP were enrolled. They were grouped according to the type of CP, diplegic (n = 38) and hemiplegic (n = 18). Threedimensional gait analyses while patient were barefoot and with AFOs were obtained and analyzed.Results The spatio-temporal findings were the most significantly changed as a result of AFO use. In the hemiplegic group, stride length was 11.7% (p = 0.001) longer with AFOs in both affected (10.2%) and nonaffected (12.4%) legs, and cadence was reduced by 9.7%; walking speed was not affected. In the diplegic group, stride length with AFOs was 17.4% longer compared to barefoot (p \ 0.001) and walking velocity improved by 17.8% (p \ 0.001); cadence was unchanged. AFOs also increased ankle dorsiflexion at initial contact in both groups. In the hemiplegic group, AFOs produced an average 9.4°increase of dorsiflexion at initial contact (IC) on the affected side (p \ 0.001) and 5.87°on the unaffected side (p = 0.007), and an increase of 9.9°(p \ 0.001) dorsiflexion at swing, on the affected side. In the diplegic group, dorsiflexion at IC was increased by 13.4°on the right side and 7.8°on the left side (p = 0.05; p [ 0.001, respectively) and an increase of 6°(p = 0.005) at swing. In the hemiplegic group of patients, knee flexion at initial contact on the affected side was reduced by 8.5°( p = 0.032) while in the diplegic group we found no influence. The number of patients that reached symmetry at initial double support tripled (from 5.6 to 16.7%) with the use of AFOs. Conclusions Our results showed that the use of AFOs improves spatio-temporal gait parameters and gait stability in children with spastic cerebral palsy. It has a lesser effect on proximal joint kinematics. Children with spastic hemiplegia display greater improvement than those with spastic diplegia.

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Section: Discussionsupporting

confidence: 92%

The effect of community-prescribed ankle–foot orthoses on gait parameters in children with spastic cerebral palsy

Hayek

Hemo

Chamis

et al. 2007

Journal of Children's Orthopaedics

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“…It has been indicated that wearing orthopedic footwear may contribute to decreased fl exion in the knee joints through increased loading of the foot while shifting and to reducing plantar fl exion while walking. It increases the effectiveness of moving of the child with ICP [34].…”

Section: Orthopedic Footwearmentioning

confidence: 99%

“…Orteza stawu kolanowego nie tylko go stabilizuje, lecz przede wszystkim stanowi podparcie dziecka w pozycji wyprostnej. Temu samemu celowi służą łuski plastikowe połączone z butami za pomocą szyny [28,34].…”

Section: Ortezy Stawu Kolanowegounclassified

“…The orthosis of the knee joint not only stabilizes it, but also supports the child in erect position. Plastic cases joined with the shoes by means of a splint have the same purpose [28,34].…”

Section: Orthoses Of the Knee Jointmentioning

confidence: 99%

“…Wykazano, że noszenie obuwia ortopedycznego może przyczyniać się do mniejszego zgięcia w stawach kolanowych poprzez zwiększenie obciążenia stopy w fazie przenoszenia oraz zmniejszenie zgięcia podeszwowego podczas chodu. Zwiększa to efektywność przemieszczania się dziecka z mpd [34].…”

Section: Obuwie Ortopedyczneunclassified

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Orthopedic equipment applied in children with cerebral palsy

Bartkowiak¹,

Łuczak-Piechowiak²,

Zgorzalewicz-Stachowiak³

et al. 2008

Physiotherapy

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Streszczenie:Leczenie mózgowego porażenia dziecięcego (mpd) opiera się na wieloetapowej, zespołowej rehabilitacji. Problematyka tego zespołu chorobowego pozostaje w kręgu zainteresowań nie tylko lekarzy, fi zjoterapeutów czy pedagogów, lecz również konstruktorów sprzętu rehabilitacyjnego i ortopedycznego. Zasadnicze znaczenie dla rozwoju psychoruchowego i dalszego funkcjonowania społecznego dziecka z mpd ma możliwość osiągnięcia przez nie zdolności samodzielnego chodzenia (nawet w zaopatrzeniu ortopedycznym) lub poruszania się w wózku inwalidzkim, a tym samym samodzielności w lokomocji. Dlatego też tak ważne jest właściwe zaopatrzenie w urządzenia rehabilitacyjne oraz pomoce ortopedyczne, ułatwiające tym dzieciom wykonywanie czynności życia codziennego. Wśród głównych celów stosowania zaopatrzenia ortopedycznego wymienia się korekcję nieutrwalonych zniekształ-ceń układu kostno-stawowego, współdziałanie przy normalizacji napięcia mięśniowego, zapewnienie pionizacji czy poprawę postawy. W postępowaniu leczniczo-usprawniającym mpd zastosowanie mają przede wszystkim ortezy, obuwie ortopedyczne, chodziki, wózki inwalidzkie, kule i trójnogi.Słowa kluczowe: zaopatrzenie ortopedyczne, mózgowe porażenie dziecięce, dzieci. Abstract:The treatment of infantile cerebral palsy (ICP) requires multistage, complex rehabilitation. The issue is not only interesting for physicians, physiotherapists or educators, but also for constructors of orthopedic and rehabilitation equipment. It is crucial for proper development and further social functioning of children with ICP that the children reach some level of independent walking (even with orthopedic aids) or moving in a wheelchair, and thus independence in locomotion. Therefore proper orthopedic equipment and walking aids are essential in their everyday activity. One of the main aims of using orthopedic equipment is to correct non-fi xed deformities of the osteoarticular system, cooperate in muscle tone normalisation, provide possibilities of tilting to erect position or to improve posture. The most commonly applied orthopedic equipment in management of ICP includes: orthoses, orthopedic footwear, walking frames, wheelchairs, crutches and tripods.Key words: orthopedic equipment, infantile cerebral palsy, children. WprowadzenieMózgowe porażenie dziecięce (mpd) przyjmuje się defi niować jako niepostępujące uszkodzenie mózgu, występujące w okresie ciąży, porodu lub okołoporodowym, prowadzące do powstania zaburzeń czynności ruchowych i postawy, które zmieniają się wraz z wiekiem. Zaburzenia rozwoju niedojrzałego mózgu mogą dawać różne objawy kliniczne, takie jak spastyczność, ruchy mimowolne o charakterze atetotycznym lub dystonicznym oraz ataksję. Leczenie mpd opiera się na trudnej i wieloetapowej zespołowej rehabilitacji. Problematyka tego zespołu chorobowego pozostaje od lat w kręgu zainteresowań nie tylko lekarzy, fi zjoterapeutów czy pedagogów, lecz również konstruktorów sprzętu rehabilitacyjnego i ortopedycznego. Zasadnicze znaczenie dla rozwoju psychoruchowego i dalszego funkcjonow...

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Correction versus bedding: Wheelchair pressure distribution measurements in children with cerebral palsy

Lampe

Mitternacht

2010

Journal of Children's Orthopaedics

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Purpose Most children with cerebral palsy classification Levels IV and V in the Gross Motor Function Classification System (GMFCS) are unable to walk and, therefore, spend almost all day in a sitting position in their wheelchairs. As a result of the spastic muscle contraction, malpositions of joints or a scoliosis develop, which require a decision to be made on whether to correct the posture or simply find the best soft bedding position. Methods The distribution of pressure on the seat while sitting in a wheelchair was measured with a pressure distribution measuring mat. The different distribution patterns were analyzed. Results Pressure distribution measurement allows to find a compromise between posture correction and soft bedding. Additionally, pressure-reducing seats were examined on their effectiveness. We also focused our measurements and data analyses on recognizing the causes for pain. Sometimes, the origin of the problems and pain of children in wheelchairs is not clear. Conclusions Using the above-mentioned measuring equipment, the causes of these problems can be detected much more easily than just by clinical examination. The pressure measuring mat can help to optimize the seating position for the spastically handicapped children and adapt technical aids. Examples demonstrate the most frequently occurring problems of these children in their wheelchairs which are typical for neuro-orthopedic diseases.

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Influence of orthopaedic-technical aid on the kinematics and kinetics of the knee joint of patients with neuro-orthopaedic diseases

Cited by 17 publications

References 2 publications

The effect of community-prescribed ankle–foot orthoses on gait parameters in children with spastic cerebral palsy

The effect of community-prescribed ankle–foot orthoses on gait parameters in children with spastic cerebral palsy

Orthopedic equipment applied in children with cerebral palsy

Correction versus bedding: Wheelchair pressure distribution measurements in children with cerebral palsy

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