Effect of ankle-foot orthoses on functional performance and physiological cost index in children with cerebral palsy

Yıl 2015, Cilt: 2 Sayı: 3, 86 - 92, 01.12.2015

Başar Öztürk , Fatma Uygur Yavuz Yakut

Öz

Purpose: This study was designed to evaluate the effectiveness of ankle foot orthoses (AFO) on functional performance and physiological cost index in children with cerebral palsy (CP).

Methods: A convenience sample of 30 children with CP (14 hemiplegics, 16 diplegics) with a mean age of 10±3 years were the subjects of the study. The children were in the first and second level of Gross Motor Functional Classification System and had been using their appropriate and comfortable AFOs regularly for at least three weeks. All of these children were properly rehabilitated by pediatric physiotherapists in rehabilitation centers at least two days in a week. The children were tested with and without AFOs by using timed up and go test, timed up and down stairs test, timed one legged stance test, one minute walk test and functional reach test. Physiological Cost Index was used to assess energy cost during the one minute walk test.

Results: A statistically significant difference was observed in favor of the AFO condition in all of the measured parameters (p<0.05) except functional reach test (p>0.05).

Conclusion: The results indicated that AFOs with correct biomechanical features improve postural control, functional performance, and physiologic cost of gait in children with CP. However if we applied a longer walking test instead of one minute walk test, results could be more valuable.

Anahtar Kelimeler

Orthosis, Cerebral palsy, Fatigue

Kaynakça

• 1. Tilton AH. Management of spasticity in children with cerebral palsy. Semin Pediatr Neurol. 2004;11:58-65.
• 2. Berker AN, Yalçın MS. Cerebral Palsy: Orthopedic Aspects and Rehabilitation. Pediatr Clin North Am. 2008;55:1209-1225.
• 3. Sanger TD, Delgado MR, Gaebler-Spira D, et al. Classification and definition of disorders causing hypertonia in childhood. Pediatrics. 2003;111:89-97.
• 4. Wood E. The child with cerebral palsy: diagnosis and beyond. Semin Pediatr Neurol. 2006;13:286-296.
• 5. Bialik GM, Givon U. Cerebral palsy: classification and etiology. Acta Orthop Traumatol Turc. 2009;43:77-80.
• 6. Piccinini L, Cimolin V, Galli M, et al. Quantification of energy expenditure during gait in children affected by cerebral palsy. Eura Medicophys. 2007;43:7-12.
• 7. Chin R, Hsiao-Wecksler T, Loth E, et al. A pneumatic power harvesting ankle-foot orthosis to prevent foot-drop. J. Neuroeng Rehabil. 2009;6:19.
• 8. Koman LA, Brashear A, Rosenfeld S, et al. Botulinum toxin type a neuromuscular blockade in the treatment of equinus foot deformity in cerebral palsy: a multicenter, open-label clinical trial. Pediatrics. 2009;108:1062-1071.
• 9. Cobeljic G, Bumbasirevic M, Lesic A, et al. The management of spastic equinus in cerebral palsy. Orthopaedics and Trauma. 2009;23:201-209.
• 10. Williams EN, Carroll SG, Reddihough DS, et al. Investigation of the timed 'up & go' test in children. Dev Med Child Neurol. 2005;47:518-524.
• 11. Zaino CA, Marchese VG, Westcott SL. Timed up and down stairs test: preliminary reliability and validity of a new measure of functional mobility. Pediatr Phys Ther. 2004;16:90-98.
• 12. McDowell BC, Kerr C, Parkes J, et al. Validity of a 1 minute walk test for children with cerebral palsy. Dev Med Child Neurol. 2005;47:744-748.
• 13. Bartlett D., Birmingham T. Validity and reliability of a pediatric reach test. Pediatr Phys Ther. 2003;15:84-92.
• 14. Verbecque E, Lobo Da Costa PH, Vereeck L, et al. Psychometric properties of functional balance tests in children: a literature review. Dev Med Child Neurol. 2014;57:521-529.
• 15. Raja K, Joseph B, Benjamin S, et al. Physiological cost index in cerebral palsy: its role in evaluating the efficiency of ambulation. Pediatr Orthop. 2007;27:130-136.
• 16. Robertson RJ, Goss FL, Boer NF, et al. Children's OMNI scale of perceived exertion: mixed gender and race validation. Med Sci Sports Exerc. 2000;32:452-458.
• 17. Bernard JC, Deceuninck J, Leroy-Coudeville S, et al. Motor function levels and pelvic parameters in walking or ambulating children with cerebral palsy. Ann Phys Rehabil Med. 2014;57:409-421.
• 18. Figueiredo EM, Ferreira GB, Maia Moreira RC, et al. Efficacy of ankle-foot orthoses on gait of children with cerebral palsy: systematic review of literature. Pediatr Phys Ther. 2008;20:207-223.
• 19. Dursun E, Dursun N, Alican D. Ankle-foot orthoses: effect on gait in children with cerebral palsy. Disabil Rehabil. 2002;24:345-347.
• 20. White H, Jenkins J, Neace WP, et al. Clinically prescribed orthoses demonstrate an increase in velocity of gait in children with cerebral palsy: a retrospective study. Dev Med Child Neurol. 2002;44:227-232.
• 21. Smiley SJ, Jacobsen FS, Mielke C, et al. A comparison of the effects of solid, articulated, and posterior leaf-spring ankle-foot orthoses and shoes alone on gait and energy expenditure in children with spastic diplegic cerebral palsy. Orthopedics. 2002;25:411-415.
• 22. Radtka SA, Skinner SR, Johanson ME. A comparison of gait with solid and hinged anklefoot orthoses in children with spastic diplegic cerebral palsy. Gait Posture. 2005;21:303-310.
• 23. Lam WK, Leong JCY, Li YH, et al. Biomechanical and electromyographic evaluation of ankle foot orthosis and dynamic ankle foot orthosis in spastic cerebral palsy. Gait Posture. 2005;22:189-197.
• 24. Buckon CE, Thomas SS, Jakobson-Huston S, et al. Comparison of three ankle foot orthosis configurations for children with spastic diplegia. Dev Med Child Neurol. 2004;46:590-598.
• 25. Katz-Leurer M, Rotem H, Keren O, et al. The effects of a `home-based' task-oriented exercise programme on motor and balance performance in children with spastic cerebral palsy and severe traumatic brain injury. Clin Rehabil. 2009;23:714-724.
• 26. Scholtes VA, Becher JG, Comuth A, et al. Effectiveness of functional progressive resistance exercise strength training on muscle strength and mobility in children with cerebral palsy: a randomized controlled trial. Dev Med Child Neurol. 2010;52:107-113.
• 27. Ijzerman MJ, Nene AV. Feasibility of the physiological cost index as an outcome measure for the assessment of energy expenditure during walking. Arch Phys Med Rehabil. 2002;83:1777-1782.