Comparison of the Effects of Foot and Ankle Orthoses in Children with Cerebral Palsy and Neuromuscular Disease on Gait Performance and Energy Expenditure

Yıl 2021, Cilt: 8 Sayı: 3, 622 - 636, 31.12.2021

Pınar Kısacık Elif Kırdı Şulenur Yıldız

Öz

Objective: The aim of this study is to compare the effects of foot and ankle orthoses used for walking in children with cerebral palsy and neuromuscular disease on walking performance and energy expenditure.
Materials and Methods: In a retrospective descriptive study design, the 6 Minute Walk Test (6MWT) was performed with and without orthoses. The evaluation results of walking distance, heart rate, respiratory rate, dyspnea, and general fatigue severity (with Borg scale) were compared between children with a diagnosis of cerebral palsy (CP) and neuromuscular disease (NMD). In addition, the Physiological Cost Index was used to calculate the energy expenditure of the children during walking.
Results: As a result of file scans, 13 (52 %) of the children who were eligible for inclusion criteria were grouped as the SP group and 12 (48 %) as the NMH group. Heart rate, respiratory rate, dyspnea, and fatigue severity values, changes in recorded walking distance, and energy consumption within the scope of 6MWT showed similar changes for both groups when performing with and without orthosis (p>0.05). In between-group comparisons, it was concluded that there was no difference between gait performance and energy consumption with and without orthosis (p>0.05).
Conclusion: This retrospective study should be considered as a valuable study in terms of presenting the effect of the choice of orthoses suitable for their conditions and the effect of gait performance in both the NMH and CP groups and the comparison between the groups. Although there is an attempt to provide an overview of the effects of ankle-ankle orthoses on gait performance and energy consumption in two different pediatric situations, more comprehensive research is needed in the field to present multifactorial effects, including biomechanical effects.

Anahtar Kelimeler

Ankle-foot orthosis, Cerebral palsy, Neuromuscular diseases, Gait, Physiologic cost index

Serebral Palsi ve Nöromusküler Hastalığı olan Çocuklarda Yürüyüş için Kullanılan Ayak ve Ayak Bileği Ortezlerinin Yürüme Performansı ve Enerji Harcamasına Etkilerinin İncelenmesi

Öz

Amaç: Bu çalışmanın amacı; serebral palsi (SP) ve nöromusküler hastalığı (NMH) olan çocuklarda yürüyüş için kullanılan ayak ve ayak bileği ortezlerinin (AFO) yürüme performansı ve enerji harcamasına etkilerinin incelenmesidir.
Gereç ve Yöntem: Retrospektif tanımlayıcı bir araştırma dizaynı içerisinde hastalara, ortez kullanmaksızın ve ortez kullanılarak uygulanmış olan 6 Dakika Yürüme Testi (6DYT) ile elde edilen yürüme mesafesi, kalp atım hızı, solunum frekansı, dispne ve genel yorgunluk şiddetinin (Borg skalası ile) değerlendirme sonuçları SP ve NMH tanısı olan çocuklar arasında karşılaştırıldı. Ayrıca çocukların yürüme sırasındaki enerji tüketimlerinin hesaplanması amacıyla Fizyolojik Harcama İndeksi kullanıldı.
Bulgular: Ocak 2018 –Aralık 2019 tarih aralığını kapsayan dosya taramaları sonucunda dahil edilme kriterlerine uygun olan çocukların 13’ü (%52) SP grubu olarak, 12’si (% 48) ise NMH grubu olarak gruplandırıldı. 6DYT kapsamında elde edilen kalp atım hızı, solunum frekansı, dispne ve yorgunluk şiddeti değerleri, kaydedilen yürüme mesafesindeki değişimler ve enerji tüketimleri her iki grup için de ortez kullanılmadığı ve kullanıldığı durumlarda benzer değişim gösterdi (p>0,05). Gruplar arası karşılaştırmalarda ortez kullanımı ile yürüyüş performansı ve enerji tüketimi açısından fark olmadığı sonucuna ulaşıldı (p>0,05).
Sonuç: Bu retrospektif çalışmada AFO kullanımının SP ve NMH’li çocuklarda tanıdan bağımsız olarak yürüyüş performansını ve enerji tüketimini etkilediği sonucuna ulaşıldı. Her ne kadar konuya ilişkin genel bir bakış sağlamaya çalışılsa da, alanda biyomekanik etkilerin de dahil edildiği çok faktörlü etkileri inceleyen daha kapsamlı araştırmalara ihtiyaç duyulduğu görülmektedir.

Anahtar Kelimeler

Ayak-ayak bileği ortezleri, Serebral palsi, Nöromusküler hastalıklar, Yürüyüş, Fizyolojik harcama indeksi

Kaynakça

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