Center for Motion Analysis at Orthopedic Surgery, Medical College of Wisconsin, Milwaukee; and Department of Orthopaedic Surgery, Children's Hospital of Wisconsin, Milwaukee, WI.
Children's Therapy Unit, MulitCare Good Samaritan Hospital, Puyallup, WA.
PM R. 2018 Mar;10(3):269-275. doi: 10.1016/j.pmrj.2017.08.438. Epub 2017 Sep 1.
Orthoses commonly are prescribed to children with cerebral palsy (CP) to provide foot correction and to improve ambulatory function. Immediate effects of ankle foot orthosis (AFOs) have been investigated, but long-term kinematic effects are lacking clinical evidence.
To determine changes in 3-dimensional ankle and foot segment motion in pediatric patients with CP between initial and follow-up visits (18-month average time differences) in both barefoot gait and gait with their AFO. We also investigated intravisit changes between barefoot and AFO gait.
A prospective cohort study.
Children's Hospital of Wisconsin, Department of Orthopaedic Surgery, Medical College of Wisconsin.
A total of 23 children with CP, mean age 10.5 years (6.2-18.1 years) were clinically prescribed either a solid ankle foot orthotic (SAFO), hinged ankle foot orthotic (HAFO), or supramalleolar orthotic.
Holes were cut in the study orthoses so that electromagnetic markers could be directly placed on the skin. A 6-foot segment model was used.
Kinematic and kinetic data were recorded for each patient's initial and follow-up visit (18-month follow-up average, 15-20 months range).
For the SAFO group (gait with AFO), a significant decrease in dorsiflexion was found between the initial and third visit (P = .008). Furthermore, the SAFO group (barefoot gait) had an increased eversion at the midfoot for most of the gait cycle (P < .008). Sagittal forefoot range of motion was reduced for all 3 groups between the barefoot and AFO groups.
The use of AFOs long term either maintained or improved foot deformities or dysfunction.
Level II.
矫形器常用于治疗脑瘫（CP）患儿，以提供足部矫正并改善步行功能。已经研究了踝足矫形器（AFO）的即时效果，但缺乏长期运动学效果的临床证据。
确定在初始和随访（平均 18 个月的时间差异）期间，在 CP 患儿的裸足和 AFO 步态中，3 维踝关节和足部节段运动的变化。我们还研究了裸足和 AFO 步态之间的单次就诊内变化。
前瞻性队列研究。
威斯康星州儿童医院，骨科，威斯康星医学院。
共有 23 名 CP 患儿，平均年龄 10.5 岁（6.2-18.1 岁），临床处方为实心踝足矫形器（SAFO）、铰链踝足矫形器（HAFO）或踝上矫形器。
在研究矫形器上切孔，以便可以将电磁标记直接放在皮肤上。使用 6 英尺的节段模型。
为每位患者的初始和随访（18 个月随访平均为 15-20 个月）记录运动学和动力学数据。
对于 SAFO 组（带 AFO 的步态），在初始和第三次就诊之间，背屈角度显著减小（P =.008）。此外，SAFO 组（裸足步态）在整个步态周期中中足的外旋角度增加（P <.008）。所有 3 组在裸足和 AFO 组之间，前足矢状面运动范围减小。
长期使用 AFO 可以维持或改善足部畸形或功能障碍。
二级。
