Guner Senem, Alsancak Serap, Güven Enver, Özgün Ali Koray
Department of Prosthetics & Orthotics, Faculty Health of Science, Ankara University, 06290 Ankara, Turkey.
Children (Basel). 2023 Apr 13;10(4):722. doi: 10.3390/children10040722.
People with spastic cerebral palsy (CP) often experience a decline in gait function and flexion. The children's posture and hip strategy, which leads to knee flexion, predisposes these children to increased contact area in the medial foot region. This study investigated the use of DAFO (dynamic ankle-foot orthosis) prescribed to patients with cerebral palsy (CP) to determine the plantar pressure distribution with orthosis use. Eight children with spastic CP (age 4-12 years) were classified as Gross Motor Function Classification System (GMFCS) levels I-II with a maximum spasticity level of 3 in their ankle muscles according to the Modified Ashworth Scale. We assessed the plantar distribution by using eight WalkinSense sensors in each trial and exported data from the proprietary software (WalkinSense version 0.96, Tomorrow Options Microelectronics, S.A.). The plantar pressure distribution was conducted under two conditions: only shoes and DAFO with shoes. The activation percentages for sensor number 1 under the 1st metatarsal and sensor number 4 under the lateral edge of the heel were significantly different under the DAFO condition. The 1-point sensor activation percentage significantly decreased, while the 4-point sensor activation percentage increased during DAFO walking. According to our study findings, there was an increase in pressure distribution in the lateral part of the foot during the stance phase in DAFO. DAFO improved the gait cycle and influenced the plantar foot pressure in children with mild cerebral palsy.
痉挛型脑瘫患者常出现步态功能下降和关节屈曲。儿童的姿势和髋部策略会导致膝关节屈曲，使这些儿童足底内侧区域的接触面积增加。本研究调查了为脑瘫患者开具的动态踝足矫形器（DAFO）的使用情况，以确定佩戴矫形器时的足底压力分布。8名痉挛型脑瘫儿童（年龄4 - 12岁）根据粗大运动功能分类系统（GMFCS）被归类为I - II级，根据改良Ashworth量表，其踝关节肌肉的最大痉挛程度为3级。我们在每次试验中使用8个WalkinSense传感器评估足底分布，并从专用软件（WalkinSense版本0.96，Tomorrow Options Microelectronics, S.A.）导出数据。足底压力分布在两种条件下进行：仅穿鞋子和穿鞋子搭配DAFO。在DAFO条件下，第一跖骨下方的1号传感器和足跟外侧边缘下方的4号传感器的激活百分比有显著差异。在佩戴DAFO行走期间，1点传感器激活百分比显著降低，而4点传感器激活百分比增加。根据我们的研究结果，在DAFO的支撑期，足部外侧的压力分布增加。DAFO改善了轻度脑瘫儿童的步态周期并影响了足底压力。
