Swinnen Eva, Baeyens Jean-Pierre, Van Mulders Benjamin, Verspecht Julian, Degelaen Marc
1 Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
2 Rehabilitation Hospital Inkendaal, Vlezenbeek, Belgium.
Prosthet Orthot Int. 2018 Apr;42(2):208-213. doi: 10.1177/0309364617706750. Epub 2017 May 9.
To improve gait function in children with cerebral palsy, ankle-foot orthoses are often prescribed. However, until now, little attention has been devoted to the effect of ankle-foot orthoses on the postural control during walking in children with cerebral palsy.
The aim was to compare the differences in thorax, spine, and pelvis movements in children with cerebral palsy during walking barefoot and walking with ankle-foot orthoses.
Clinical study with an intra subject design.
A total of 15 children (12 boys and 3 girls; mean age, 8 ± 2 years) with bilateral spastic cerebral palsy (12 with Gross Motor Function Classification System I and 3 with Gross Motor Function Classification System II) performed a full-body three-dimensional gait analysis. Differences in the range of motion of the thorax, spine, and pelvis during walking barefoot and walking with bilateral ankle-foot orthoses were analyzed (SPSS v20, paired-samples t-test).
Children with cerebral palsy showed a significantly larger range of motion of the thorax (flexion/extension, lateral bending, and rotation) and the spine (lateral bending) during walking with ankle-foot orthoses compared to walking barefoot. No significant differences were found in the range of motion of the pelvis between these two conditions.
It can be concluded that wearing ankle-foot orthoses influences the postural control during walking in children with bilateral spastic cerebral palsy. Due to the increased range of motions, the movement pattern of the trunk diverges from the typically developing children. Clinical relevance Wearing ankle-foot orthoses not only gives more stability at the pelvis and ankle joint but also influences trunk motion. In order of the level of core stability of the child, compensations can be either seen in the lower back or the upper trunk. Clinicians should be aware of these compensations and should evaluate postural control in a more detailed evaluation.
为改善脑瘫患儿的步态功能，通常会开具踝足矫形器。然而，迄今为止，很少有人关注踝足矫形器对脑瘫患儿行走时姿势控制的影响。
旨在比较脑瘫患儿在赤足行走和佩戴踝足矫形器行走时胸部、脊柱和骨盆运动的差异。
采用受试者内设计的临床研究。
总共15名双侧痉挛性脑瘫患儿（12名男孩和3名女孩；平均年龄8±2岁，其中12名患儿的粗大运动功能分级系统为I级，3名患儿为II级）进行了全身三维步态分析。分析了赤足行走和佩戴双侧踝足矫形器行走时胸部、脊柱和骨盆的运动范围差异（使用SPSS v20软件进行配对样本t检验）。
与赤足行走相比，脑瘫患儿佩戴踝足矫形器行走时胸部（屈伸、侧屈和旋转）和脊柱（侧屈）的运动范围明显更大。两种情况下骨盆的运动范围未发现显著差异。
可以得出结论，佩戴踝足矫形器会影响双侧痉挛性脑瘫患儿行走时的姿势控制。由于运动范围增加，躯干的运动模式与正常发育儿童不同。临床意义：佩戴踝足矫形器不仅能增加骨盆和踝关节的稳定性，还会影响躯干运动。根据患儿核心稳定性的水平，代偿可能出现在下背部或上躯干。临床医生应意识到这些代偿情况，并应在更详细的评估中评估姿势控制。
Zotero 插件