Danino Barry, Erel Snir, Kfir Meital, Khamis Sam, Batt Reuven, Hemo Yoram, Wientroub Shlomo, Hayek Shlomo
*Department of Pediatric Orthopaedics ‡The Gait and Motion Analysis Laboratory, Dana Children's Hospital, Tel-Aviv Sourasky Medical Center †Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
J Pediatr Orthop. 2016 Apr-May;36(3):294-8. doi: 10.1097/BPO.0000000000000429.
Neuromuscular impairments may compromise gait function in patients with cerebral palsy (CP). As such, ambulatory children with CP often use ankle foot orthosis (AFO) to facilitate and optimize their ability to walk.The aim of this study was to evaluate whether the different gait indices, the Gillette Gait Index (GGI), the Gait Deviation Index (GDI), and the Gait Profile Score (GPS), reflect the improved gait that was previously shown using AFO.
A retrospective analysis of 53 studies on children with spastic diplegic CP. All had undergone a comprehensive gait study and were analyzed while walking, both barefoot and with their braces, in the same session.Kinematic and temporal spatial data were determined and summarized by 3 methods: GPS, GDI, and GGI.
Significant differences were found between the barefoot condition and the AFO conditions for temporal and kinematic parameters: changes in GGI, GDI, and GPS were not statistically significant, with an improvement of 9.33% in GGI (P=0.448) and no change in GDI and GPS.
The use of AFO in diplegic CP children caused a statistically significant improvement in temporal and kinematic parameters. Interestingly, it was found that this improvement was not reflected by GGI, GDI, or GPS.These findings might suggest that gait indices, as outcome measures, may sometimes not reflect all the effects of specific interventions.
Level III-retrospective study.
神经肌肉功能障碍可能会损害脑瘫（CP）患者的步态功能。因此，患有CP的能行走儿童经常使用踝足矫形器（AFO）来促进和优化他们的行走能力。本研究的目的是评估不同的步态指标，即吉列步态指数（GGI）、步态偏差指数（GDI）和步态轮廓评分（GPS），是否能反映先前使用AFO所显示的步态改善情况。
对53项关于痉挛性双侧瘫CP儿童的研究进行回顾性分析。所有儿童均接受了全面的步态研究，并在同一会诊中分别在赤脚和佩戴支具行走时进行分析。通过3种方法确定并汇总运动学和时空数据：GPS、GDI和GGI。
在赤脚状态和AFO状态之间，发现时间和运动学参数存在显著差异：GGI、GDI和GPS的变化无统计学意义，GGI改善了9.33%（P = 0.448），GDI和GPS无变化。
在双侧瘫CP儿童中使用AFO导致时间和运动学参数有统计学意义的改善。有趣的是，发现这种改善并未被GGI、GDI或GPS所反映。这些发现可能表明，作为结局指标的步态指数有时可能无法反映特定干预措施的所有效果。
III级——回顾性研究。
