The influence of ankle-foot orthoses on gait pathology in children with cerebral palsy: A retrospective study

Everaert, Laure; Papageorgiou, Eirini; Campenhout, Anja Van; Labey, Luc; Desloovere, Kaat

doi:10.1016/j.gaitpost.2022.11.063

Cited by 9 publications

(4 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For children with apparent equinus, a decrease in ankle power generation during push-off and a better ankle position during the swing, as well as a decrease in knee flexion during terminal stance, were observed. The use of AFO can prevent the midfoot brake, which leads to a correct roll-off that increases the lever arm, resulting in a correspondingly high plantar flexion moment [ 43 ]. There is strong evidence for changes in biomechanical parameters during gait, particularly an increase in ankle dorsiflexion value at initial contact and during a swing, using posterior AFOs in children with equinus gait, and if the goal is to improve ankle kinematics in a child with unilateral or bilateral cerebral palsy, dynamic AFO is indicated to be appropriate [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Five-Foot Plantar Morphological Pressure Points of Children with Cerebral Palsy Using or Not Dynamic Ankle Foot Orthosis

et al. 2023

View full text Add to dashboard Cite

People with spastic cerebral palsy (CP) often experience a decline in gait function and flexion. The children’s posture and hip strategy, which leads to knee flexion, predisposes these children to increased contact area in the medial foot region. This study investigated the use of DAFO (dynamic ankle–foot orthosis) prescribed to patients with cerebral palsy (CP) to determine the plantar pressure distribution with orthosis use. Eight children with spastic CP (age 4–12 years) were classified as Gross Motor Function Classification System (GMFCS) levels I-II with a maximum spasticity level of 3 in their ankle muscles according to the Modified Ashworth Scale. We assessed the plantar distribution by using eight WalkinSense sensors in each trial and exported data from the proprietary software (WalkinSense version 0.96, Tomorrow Options Microelectronics, S.A.). The plantar pressure distribution was conducted under two conditions: only shoes and DAFO with shoes. The activation percentages for sensor number 1 under the 1st metatarsal and sensor number 4 under the lateral edge of the heel were significantly different under the DAFO condition. The 1-point sensor activation percentage significantly decreased, while the 4-point sensor activation percentage increased during DAFO walking. According to our study findings, there was an increase in pressure distribution in the lateral part of the foot during the stance phase in DAFO. DAFO improved the gait cycle and influenced the plantar foot pressure in children with mild cerebral palsy.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessment of Five-Foot Plantar Morphological Pressure Points of Children with Cerebral Palsy Using or Not Dynamic Ankle Foot Orthosis

et al. 2023

View full text Add to dashboard Cite

show abstract

“…After determining statistical significance, the clinical relevance of these findings was judged. Following an approach that was previously established 44 , the differences in spatiotemporal parameters should exceed previously reported minimal detectable changes (MDC) 45 . Per suprathreshold cluster from the SPM results, the duration should be longer or equal to 3% of the GC and the differences in the segment/joint waveforms between groups should be larger than the respective standard errors of measurements (SEM) for the intra-rater intersession reliability in TD by Kainz et al 38 (for pelvis and lower limb) and Wilken et al 46 (for trunk) for 80% or more of the suprathreshold cluster’s duration.…”

Section: Methodsmentioning

confidence: 99%

Gait classification for growing children with Duchenne muscular dystrophy

Vandekerckhove,

Papageorgiou,

Hanssen

et al. 2024

Sci Rep

Self Cite

View full text Add to dashboard Cite

Classifying gait patterns into homogeneous groups could enhance communication among healthcare providers, clinical decision making and clinical trial designs in boys with Duchenne muscular dystrophy (DMD). Sutherland’s classification has been developed 40 years ago. Ever since, the state-of-the-art medical care has improved and boys with DMD are now longer ambulatory. Therefore, the gait classification requires an update. The overall aim was to develop an up-to-date, valid DMD gait classification. A total of 137 three-dimensional gait analysis sessions were collected in 30 boys with DMD, aged 4.6–17 years. Three classes were distinguished, which only partly aligned with increasing severity of gait deviations. Apart from the mildly affected pattern, two more severely affected gait patterns were found, namely the tiptoeing pattern and the flexion pattern with distinct anterior pelvic tilt and posterior trunk leaning, which showed most severe deviations at the ankle or at the proximal segments/joints, respectively. The agreement between Sutherland’s and the current classification was low, suggesting that gait pathology with the current state-of-the-art medical care has changed. However, overlap between classes, especially between the two more affected classes, highlights the complexity of the continuous gait changes. Therefore, caution is required when classifying individual boys with DMD into classes.

show abstract

“…The alpha level for the post hoc t-test was 0.004 (i.e., 0.05/(3 × 4), because of the Bonferroni correction for multiple testing in the comparison of the three conditions, for each of the four continuous waveforms, namely pelvis, hip, knee and ankle). The size of the significant cluster needed to be at least 3% to be considered clinically relevant [26].…”

Section: Data Collection and Data Analysismentioning

confidence: 99%

A Comparison of the Immediate Effects of Verbal and Virtual Reality Feedback on Gait in Children with Cerebral Palsy

De Mulder,

Adams,

Dewit

et al. 2024

Children

Self Cite

View full text Add to dashboard Cite

Different types of feedback are used during gait training in children with cerebral palsy (CP), including verbal (VB) and virtual reality (VR) feedback. Previous studies on VR feedback showed positive effects on the targeted gait parameter. However, both positive and negative side effects on other parameters were seen as well. The literature on the effect of VB feedback is lacking and, to our knowledge, both feedback methods have not yet been compared. In this monocentric study with a single-session intervention protocol, children with CP completed a training session on the Gait Real-Time Analysis Interactive Lab (GRAIL) and received both VB and VR feedback on hip extension, in randomized order. Outcome parameters were continuous gait curves of sagittal kinematics and hip kinetics, specific features of hip angle and moment, sagittal gait variable scores and gait profile scores. Improvement of the targeted gait parameter was seen both after VB and VR feedback, with a small advantage for VR over VB feedback. Furthermore, positive side effects on knee and ankle sagittal kinematics were seen. However, the overall gait profile score did not improve, most likely due to negative compensatory strategies. In conclusion, children with CP can adapt gait in response to both VB and VR feedback, with VR feedback producing a slightly better effect. Due to secondary effects on parameters other than the targeted parameter, the overall gait did not improve.

show abstract

The influence of ankle-foot orthoses on gait pathology in children with cerebral palsy: A retrospective study

Cited by 9 publications

References 27 publications

Assessment of Five-Foot Plantar Morphological Pressure Points of Children with Cerebral Palsy Using or Not Dynamic Ankle Foot Orthosis

Assessment of Five-Foot Plantar Morphological Pressure Points of Children with Cerebral Palsy Using or Not Dynamic Ankle Foot Orthosis

Gait classification for growing children with Duchenne muscular dystrophy

A Comparison of the Immediate Effects of Verbal and Virtual Reality Feedback on Gait in Children with Cerebral Palsy

Contact Info

Product

Resources

About