Goihl Tobias, Rusaw David F, Roeleveld Karin, Brændvik Siri Merete
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
Trøndelag Orthopaedic Workshop, TOV, Trondheim, Norway.
J Rehabil Assist Technol Eng. 2024 Sep 27;11:20556683241276804. doi: 10.1177/20556683241276804. eCollection 2024 Jan-Dec.
Practice of ankle-foot orthoses (AFO) provision for ambulatory children with cerebral palsy is underreported and the literature is not consistent on choice of AFO-design. This study describes clinical practice of AFO provision for children with cerebral palsy and evaluates how clinical practice aligns with existing recommendations.
An online, cross-sectional survey was conducted, inviting all Norwegian orthotists working with children with cerebral palsy. Orthotic practice was investigated using a self-reported survey design.
From all eligible orthotists, 54% responded, revealing that AFO provision involves patients, physicians, and physiotherapists at different stages. Patient preference directly influenced the ultimate AFO-design. Shank vertical angle was evaluated by 79%. For children with crouch gait and those with short gastrocnemius, a majority preferred a combination of rigid and articulated/flexible AFO-designs. Instrumented gait analysis was conducted by 51% at AFO delivery stage.
The findings show that AFO provision in Norway is collaborative, involving clinical team members and consideration of patient preferences. A discrepancy between clinical practice and existing recommendations for children with crouch gait and those with short gastrocnemius is observed.
为患有脑瘫的能行走儿童提供踝足矫形器（AFO）的实践报告较少，并且关于AFO设计的选择，文献观点并不一致。本研究描述了为患有脑瘫儿童提供AFO的临床实践，并评估临床实践与现有建议的契合程度。
开展了一项在线横断面调查，邀请所有为患有脑瘫儿童工作的挪威矫形师参与。使用自我报告的调查设计对矫形实践进行调查。
在所有符合条件的矫形师中，54%做出了回应，结果显示提供AFO在不同阶段涉及患者、医生和物理治疗师。患者的偏好直接影响最终的AFO设计。79%的人会评估小腿垂直角度。对于蹲伏步态的儿童和腓肠肌较短的儿童，大多数人更喜欢刚性与关节式/柔性AFO设计的组合。在AFO交付阶段，51%的人进行了步态分析。
研究结果表明，挪威提供AFO是协作性的，涉及临床团队成员并考虑患者偏好。观察到在为蹲伏步态儿童和腓肠肌较短儿童提供AFO的临床实践与现有建议之间存在差异。
