Bjornson Kristie, Zhou Chuan, Fatone Stefania, Orendurff Michael, Stevenson Richard, Rashid Sariya
Seattle Children's Research Institute (Drs Bjornson and Zhou and Ms Rashid), University of Washington, Seattle, Washington; Northwestern Prosthetics Research Laboratory and Rehabilitation Engineering Research Program and Physical Medicine and Rehabilitation Department (Dr Fatone), Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Orthocare Innovations (Dr Orendurff), Mountlake Terrace, Washington; Division of Developmental and Behavioral Pediatrics (Dr Stevenson), Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
Pediatr Phys Ther. 2016 Summer;28(2):179-86. doi: 10.1097/PEP.0000000000000242.
To examine the effect of ankle-foot orthoses (AFO) on walking activity in children with cerebral palsy (CP).
We used a randomized cross-over design with 11 children with bilateral CP, mean age 4.3 years. Subjects were randomized to current AFO-ON or AFO-OFF for 2 weeks and then crossed over. Walking activity (average total steps/day), intensity, and stride rate curves were collected via an ankle accelerometer. Group effects were examined with the Wilcoxon signed-rank test and within-subject effects examined for more than 1 standard deviation change.
No significant group difference was found in average total daily step count between treatment conditions (P = .48). For the AFO-ON condition, 2 subjects (18%) increased total steps/day; 4 (36%) increased walking time; 2 (18%) had more strides at a rate of more than 30 strides/min; and 2 (18%) reached higher peak intensity.
Clinically prescribed AFO/footwear did not consistently enhance walking activity levels or intensity. Larger studies are warranted.
研究踝足矫形器（AFO）对脑瘫（CP）患儿步行活动的影响。
我们采用随机交叉设计，纳入11名双侧脑瘫患儿，平均年龄4.3岁。受试者被随机分为佩戴现有AFO（AFO-ON）或不佩戴AFO（AFO-OFF）两组，每组持续2周，之后进行交叉。通过脚踝加速度计收集步行活动（平均每日总步数）、强度和步频曲线。采用Wilcoxon符号秩检验来检验组间效应，并对超过1个标准差变化的受试者内效应进行检验。
治疗条件之间的平均每日总步数未发现显著的组间差异（P = 0.48）。在AFO-ON组中，2名受试者（18%）每日总步数增加；4名（36%）步行时间增加；2名（18%）步频超过30步/分钟的步数增多；2名（18%）达到更高的峰值强度。
临床处方的AFO/鞋类并不能持续提高步行活动水平或强度。有必要开展更大规模的研究。
