Gillette Children's Specialty Healthcare, St Paul, MN, USA.
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA.
Dev Med Child Neurol. 2019 Feb;61(2):219-225. doi: 10.1111/dmcn.13999. Epub 2018 Aug 26.
To investigate any performance differences between the solid ankle-foot orthosis (SAFO) and ground reaction ankle-foot orthosis (GRAFO) designs for correcting crouch gait in children diagnosed with cerebral palsy (CP).
We retrospectively analyzed 147 individuals seen at our center who: (1) were diagnosed with diplegic CP, (2) walked with crouch gait, (3) had bilateral SAFO or GRAFO prescription, and (4) had three-dimensional gait analysis collected for both barefoot and orthosis walking conditions.
Overall, no performance gap was identified between the SAFO and GRAFO groups (p=0.828). A series of bootstrapped stepwise regression analyses indicated that ankle-foot orthosis (AFO) design was not predictive of crouch gait improvements. Improvements in crouch gait were instead shown to be predicted by AFO neutral angle and four patient factors: amount of dorsiflexion in stance, level of knee flexion contracture, age, and severity of crouch.
Our results show that the SAFO and GRAFO designs are equally effective at correcting crouch gait for individuals diagnosed with CP.
No performance difference was detected between solid ankle-foot orthoses and ground reaction ankle-foot orthoses designs for crouch gait correction. Crouch gait improvement from ankle-foot orthoses (AFO) is influenced by AFO neutral angle. Other factors of influence include: dorsiflexion in stance, level of knee flexion contracture, age, and severity of crouch.
研究在矫正脑瘫儿童蹲姿步态时，实心踝足矫形器（SAFO）和地面反应踝足矫形器（GRAFO）设计之间的任何性能差异。
我们回顾性分析了在我们中心就诊的 147 名个体，这些个体符合以下条件：（1）被诊断为双瘫脑瘫，（2）以蹲姿步态行走，（3）双侧 SAFO 或 GRAFO 处方，（4）在赤脚和矫形器行走条件下均采集了三维步态分析。
总体而言，SAFO 和 GRAFO 组之间未发现性能差距（p=0.828）。一系列引导逐步回归分析表明，踝足矫形器（AFO）设计不能预测蹲姿步态改善。相反，AFO 中立角度和四个患者因素预测了蹲姿步态的改善：站立时背屈的程度、膝关节屈曲挛缩的程度、年龄和蹲姿的严重程度。
我们的结果表明，在矫正 CP 患者的蹲姿步态方面，SAFO 和 GRAFO 设计同样有效。
在矫正蹲姿步态方面，实心踝足矫形器和地面反应踝足矫形器设计之间未检测到性能差异。AFO 中立角度影响 AFO 对蹲姿步态的改善。其他影响因素包括：站立时的背屈程度、膝关节屈曲挛缩的程度、年龄和蹲姿的严重程度。
