Belizón-Bravo Natalia, Romero-Galisteo Rita Pilar, Cano-Bravo Fatima, Gonzalez-Medina Gloria, Pinero-Pinto Elena, Luque-Moreno Carlos
Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain.
Department of Physiotherapy, Biomedical Research Institute of Malaga (IBIMA), University of Málaga, 29071 Málaga, Spain.
Children (Basel). 2021 Nov 5;8(11):1016. doi: 10.3390/children8111016.
Dynamic suit orthoses (DSO) are currently used as a complementary treatment method in children with Cerebral Palsy (cwCP). The aim of this review was to assess the effects of interventions with DSO on the altered spatio-temporal gait parameters (STGPs) in cwCP. An electronic search was conducted in the Web of Science, Scopus, PEDro, Cochrane Library, MEDLINE/PubMed, and CINAHL databases up to July 2021. We included a total of 12 studies, which showed great heterogeneity in terms of design type, sample size, and intervention performed (two employed a Therasuit, three employed the Adeli suit, three employed Theratogs, one employed elastomeric tissue dynamic orthosis, one employed a full-body suit, one employed external belt orthosis, and one employed dynamic orthosis composed of trousers and T-shirt). The Cochrane collaboration's tool and the Checklist for Measuring Study Quality were used to assess the risk of bias and the methodological quality of the studies. It was variable according to the Checklist for Measuring Study Quality, and it oscillated between eight and 23. The studies of higher methodological quality showed significant post-intervention changes in walking speed (which is the most widely evaluated parameter), cadence, stride length, and step length symmetry. Although the evidence is limited, the intervention with DSO combined with a programme of training/physical therapy seems to have positive effects on the STGPs in cwCP, with the functional improvements that it entails. Despite the immediate effect after one session, a number of sessions between 18 and 60 is recommended to obtain optimum results. Future studies should measure all STGPs, and not only the main ones, such as gait speed, in order to draw more accurate conclusions on the functional improvement of gait after the use of this type of intervention.
动态套装矫形器（DSO）目前被用作脑瘫患儿（cwCP）的一种辅助治疗方法。本综述的目的是评估DSO干预对cwCP患儿时空步态参数（STGPs）改变的影响。截至2021年7月，在科学网、Scopus、PEDro、Cochrane图书馆、MEDLINE/PubMed和CINAHL数据库中进行了电子检索。我们共纳入了12项研究，这些研究在设计类型、样本量和实施的干预方面存在很大异质性（两项使用了Therasuit，三项使用了Adeli套装，三项使用了Theratogs，一项使用了弹性组织动态矫形器，一项使用了全身套装，一项使用了外部腰带矫形器，一项使用了由裤子和T恤组成的动态矫形器）。使用Cochrane协作工具和测量研究质量清单来评估研究的偏倚风险和方法学质量。根据测量研究质量清单，结果各不相同，在8到23之间波动。方法学质量较高的研究显示，干预后步行速度（这是评估最广泛的参数）、步频、步长和步长对称性有显著变化。尽管证据有限，但DSO干预结合训练/物理治疗方案似乎对cwCP患儿的STGPs有积极影响，并带来相应的功能改善。尽管一次治疗后有即时效果，但建议进行18至60次治疗以获得最佳效果。未来的研究应测量所有的STGPs，而不仅仅是主要的参数，如步态速度，以便对使用这种干预后步态的功能改善得出更准确的结论。
