Miccinilli Sandra, Santacaterina Fabio, Della Rocca Rebecca, Sterzi Silvia, Bressi Federica, Bravi Marco
Department of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy.
Research Unit of Physical and Reahabilitation Medicine, Department of Medicine and Surgery, Università Campus Bio-Medico di Rome, Via Alvaro del Portillo, 21, 00128 Rome, Italy.
Children (Basel). 2024 Feb 6;11(2):212. doi: 10.3390/children11020212.
Lower limb orthoses are frequently used in children suffering from cerebral palsy (CP) alongside rehabilitation. The aim of this study was to analyze the effectiveness of ankle-foot orthosis (AFO) and knee-ankle-foot orthosis (KAFO) in walking, balance maintenance, spasticity, and quality of life improvement during rehabilitation in children affected by CP. The hypothesis was that the use of orthoses could improve the parameters compared to non-use. A systematic review was conducted in the main databases, including English language RCTs published about the use of AFO and KAFO in combination or not with rehabilitation methods in children affected by CP and studies mentioning walking, balance, muscle length, and quality of life as outcomes. From an initial number of 1484 results, a final number of 11 RCTs were included, comprising a total number of 442 participants and showing an overall high risk of bias in 10 studies and some concerns in one study. Six studies investigated the domain of walking, four studies investigated the domain of balance, and two studies investigated how KAFO and AFO orthoses could improve and prevent muscle contractures. Using highly heterogeneous study designs, different kinds of orthoses and different assessment tools were used. Further studies conducted with higher methodological quality are needed to establish whether AFO and KAFO are useful or not in combination with rehabilitation in improving the investigated domains.
下肢矫形器经常用于脑瘫(CP)患儿的康复治疗中。本研究的目的是分析踝足矫形器(AFO)和膝踝足矫形器(KAFO)在受CP影响的儿童康复过程中对行走、平衡维持、痉挛以及生活质量改善方面的有效性。假设是与不使用矫形器相比,使用矫形器可以改善相关参数。在主要数据库中进行了一项系统评价,包括发表的关于AFO和KAFO单独或与康复方法联合用于受CP影响儿童的英文随机对照试验(RCT),以及提及行走、平衡、肌肉长度和生活质量作为结果的研究。从最初的1484个结果中,最终纳入了11项RCT,共442名参与者,其中10项研究显示总体存在高偏倚风险,1项研究存在一些问题。6项研究调查了行走领域,4项研究调查了平衡领域,2项研究调查了KAFO和AFO矫形器如何改善和预防肌肉挛缩。研究采用了高度异质性的设计,使用了不同类型的矫形器和不同的评估工具。需要进行更高方法学质量的进一步研究,以确定AFO和KAFO与康复联合使用在改善所研究领域方面是否有用。