Pediatric Physical Therapy Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
Prosthet Orthot Int. 2022 Feb 1;46(1):2-6. doi: 10.1097/PXR.0000000000000060.
The children with diplegic cerebral palsy (CP) commonly have abnormal alignment of lower extremities affecting their abilities of keeping balance. Orthoses are one of the many approaches that can be prescribed to improve balance and walking in diplegic children.
This study was conducted to assess the moderate effect of solid ankle foot orthosis (AFO) vs. the ground reaction ankle foot orthosis (GRAFO) on balance in children with diplegic CP.
A randomized controlled trial.
Thirty children with spastic diplegic CP from both genders participated in this study; their ages were between 6 and 9 years. They were divided randomly into two study groups of equal numbers; the first study group A received the regular physical therapy program besides wearing the AFO for successive three months. The second study group B received the regular physical therapy program besides wearing the GRAFO for successive 3 months. All childrens' balance was evaluated before starting the treatment program and after 3 months by using the Biodex balance system (anteroposterior and mediolateral stability indices).
There were significant improvement of all stability indices in both groups (P < 0.05), with significant difference between groups when comparing post-treatment mean values of the measured indices in favor to study group B (P < 0.05).
The GRAFO achieved more balance control in children with spastic diplegic CP compared with solid AFO.
患有双瘫脑瘫（CP）的儿童下肢通常存在排列异常，影响其平衡能力。矫形器是改善双瘫儿童平衡和行走能力的众多方法之一。
本研究旨在评估硬踝足矫形器（AFO）与地面反应踝足矫形器（GRAFO）对双瘫 CP 儿童平衡的中等影响。
随机对照试验。
30 名来自两性的痉挛性双瘫 CP 儿童参与了这项研究；他们的年龄在 6 至 9 岁之间。他们被随机分为两组，每组人数相等；第一组 A 除了连续三个月穿 AFO 外，还接受常规物理治疗方案。第二组 B 在接受常规物理治疗方案的同时，连续 3 个月穿 GRAFO。在开始治疗计划之前和 3 个月后，所有儿童的平衡都使用 Biodex 平衡系统（前后向和左右向稳定性指数）进行评估。
两组的所有稳定性指数均有显著改善（P < 0.05），治疗后测量指数的组间均值差异具有统计学意义，有利于研究组 B（P < 0.05）。
与硬踝足矫形器相比，GRAFO 可实现对痉挛性双瘫 CP 儿童更优的平衡控制。
