踝足矫形器对脑瘫患者社区行走能力的影响：一项临床初步研究。
The Effect of Ankle-Foot Orthoses on Community-Based Walking in Cerebral Palsy: A Clinical Pilot Study.
作者信息
Bjornson Kristie, Zhou Chuan, Fatone Stefania, Orendurff Michael, Stevenson Richard, Rashid Sariya
机构信息
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.
出版信息
Pediatr Phys Ther. 2016 Summer;28(2):179-86. doi: 10.1097/PEP.0000000000000242.
PURPOSE
To examine the effect of ankle-foot orthoses (AFO) on walking activity in children with cerebral palsy (CP).
METHODS
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.
RESULTS
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.
CONCLUSIONS
Clinically prescribed AFO/footwear did not consistently enhance walking activity levels or intensity. Larger studies are warranted.
目的
研究踝足矫形器（AFO）对脑瘫（CP）患儿步行活动的影响。
方法
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。
结果
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。
结论
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。
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