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Purpose: Spastic diplegia is the most common form of cerebral palsy. It presents with symmetric involvement of the lower limbs and upper limbs. Children with spastic diplegia frequently experience problems with motor control, spasticity, and balance which lead to gait abnormalities. The aim of this study is twofold. Firstly, to determine the differences in spatial-temporal gait parameters and magnitude of plantar pressure distribution between children with spastic diplegia (CP) and typical children. Secondly, to compare and evaluate main changes of plantar pressure and spatial-temporal gait parameters instead of data between spastic diplegia children with prescribed ankle – solid foot orthosis (AFOs) and without using AFOs. Methods: The evaluation was carried out on 20 spastic diplegia children and 10 agematched children as a control group aged 6–15 years. Twenty children with spastic diplegia CP were divided into two groups: ten subjects with prescribed AFOs and ten subjects without use of assistive device. Patients used the AFOs orthosis for one year. Measurements included in-shoe plantar pressure distribution and spatial-temporal gait parameters. Results: Spatial-temporal gait parameters showed meaningful difference between study groups in velocity, stride length, step length and cadence ( p < 0.05). However no significant differences between patients with and without AFOs were found ( p > 0.05). Significant differences between typical and spastic diplegia children with AFOs were observed in the magnitude of plantar pressure under the toes, the metatarsal heads, the medial arch, and the heel ( p < 0.05). For typical subjects, the highest pressure amplitudes were found under the heel and the metatarsal heads, while the lowest pressure distribution was under the medial arch. In CP patients the lateral arch was strongly unloaded. The peak pressure under heel was shifted inside. Conclusions: Collected data and calculated scores present a state of the gait in test groups, showed the difference and could be valuable for physicians in decision making by choosing qualitative therapy. Furthermore, it allows predicting probability of further possible changes in gait of spastic diplegia patients with AFOs and without it. In conclusion, our current results showed that the use of AFOs, prescribed on a clinical basis by doctors improves gait patterns and gait stability in children with spastic cerebral palsy.
Czasopismo
Rocznik
Tom
Strony
121--129
Opis fizyczny
Bibliogr. 24 poz., rys., tab., wykr.
Twórcy
autor
- Białystok University of Technology, Białystok, Poland
autor
- Yanka Kupala State University of Grodno, Grodno, Belarus
autor
- Vilnius Gediminas Technical University, Vilnius, Lithuania
autor
- Grodno State Medical University, Grodno, Belarus
autor
- Vilnius Gediminas Technical University, Vilnius, Lithuania
Bibliografia
- [1] ABEL M.F., DAMIANO D.L., Strategies for increasing walking speed in diplegic cerebral palsy, J. Pediatr. Orthop., 1996, Vol. 16, 753–758.
- [2] BAX M., GOLDSTEIN M., ROSENBAUM P., LEVITON A., PANETH N., DAN B., JACOBSSON B., DAMIANO D., Executive Committee for the Definition of Cerebral Palsy: Proposed definition and classification of cerebral palsy, Dev. Med. Child Neurol., 2005, Vol. 47, 571–576.
- [3] BJORNSON K., GRAUBERT C., MCLAUGHLIN J., Test-retest reliability of the gross motor function measure in children with cerebral palsy, Pediatr. Phys. Ther., 2000, Vol. 12, 200–202.
- [4] BJORNSON K.F., BELZA B., KARTIN D., LOGSDON R., MCLAUGHLIN J.F., Ambulatory physical activity performance in youth with cerebral palsy and youth who are developing typically, Phys. Ther., 2007, Vol. 87, 248–257.
- [5] BUCKON C.E., THOMAS S.S., JAKOBSON-HUSTON S., MOOR M., SUSSMAN M., AIONA M., Comparison of three ankle–foot orthosis configurations for children with spastic diplegia, Dev. Med. Child Neurol., 2004, Vol. 46, 590–598.
- [6] BURNFIELD J.M., Gait and Posture, 2nd ed., New Jersey, SLACK 2010.
- [7] BURTNER P.A., WOOLLACOTT M.H., QUALLS C., Stance balance control with orthoses in a group of children with spastic cerebral palsy, Dev. Med. Child Neurol., 1999, Vol. 41, 748–757.
- [8] CHANG J.K., SUNG M.S., Comparison of Spatiotemporal Gait parameters between Children with Normal Development and Children with Diplegic Cerebral Palsy, J. Phys. Ther. Sci., 2014, Vol. 26, 1317–1319.
- [9] CHANG W.D., CHANG N.J., LIN H.Y., LAI P.T., Changes of plantar pressure and gait parameters in children with mild cerebral palsy who used a customized external strap orthosis: A crossover study, BioMed Research International, 2015, Vol. 2015, 1–8.
- [10] DURSUN E., DURSUN N., ALICAN D., Ankle–foot orthoses: effect on gait in children with cerebral palsy, Disabil. Rehabil., 2002, Vol. 24, 345–347.
- [11] GALI M., CIMOLIN V., LEBAN B., BRUNNER R., ALBERTINI G., Foot pressure distribution in children with cerebral palsy while standing, Res. Dev. Disabil., 2015, Vol. 41–42, 52–57.
- [12] HAYEK S., HEMO Y., CHAMIS S, BAT R., SEGEV E., WIENTROUB S., YZHAR Z., The effect of community-prescibed ankle-foot orthoses on gait parameters in children with spastic cerebral palsy, J. Child Orthop., 2007, Vol. 1(6), 325–332.
- [13] JAHNSEN R., VILLIEN L., AAMODT G., STANGHELLE J.K., HOLM I., Musculoskeletal pain in adults with cerebral palsy compared with the general population, J. Rehabil. Med., 2004, Vol. 36, 78–84.
- [14] JOHNSON D.C., DAMIANO D.L., ABEL M.F., The evolution of gait in childhood and adolescent cerebral palsy, J. Pediatr. Orthop., 1997, Vol. 17, 392–396.
- [15] KURZ M.J., ARPIN D.J., CORR B., Differences in the dynamic gait stability of children with cerebral palsy and typically developing children, Gait Posture, 2012, Vol. 36, 600–604.
- [16] MARK F., ABEL M.D., JUHL G.A., Gait assessment of fixed ankle-foot orthoses in children with spastic diplegia, Arch. Phys. Med. Rehabil., 1998, Vol. 79, 126–133.
- [17] OEFFINGER D.J., TYLKOWSKI C.M., RAYENS M.K., DAVIS R.F., GORTON G.E.3RD, D’ASTOUS J., NICHOLSON D.E., DAMIANO D.L., ABEL M.F., BAGLEY A.M., LUAN J., Gross Motor Function Classification System and outcome tools for assessing ambulatory cerebral palsy: a multicenter study, Dev. Med. Child Neurol., 2004, Vol. 46, 311–319.
- [18] PAUK J., DAUNORAVICIENE K., IHNATOUSKI M., GRISKEVICIUS J., RASO J.V., Analysis of the plantar pressure distribution in children with foot deformation, Acta Bioeng. Biomech., 2010, Vol. 12(1), 29–34.
- [19] ROSENBAUM P.L., WALTER S.D., HANNA S.E., PALISANO R.J., RUSSELL D.J., RAINA P., WOOD E., BARTLETT D.J., GALUPPI B.E., Prognosis for gross motor function in cerebral palsy: creation of motor development curves, JAMA, 2002, Vol. 288, 1357–1363.
- [20] STEELE K.M., DEMERS M.S., SCHWARTZ M.H., DELP S.L., Compressive tibiofemoral force during crouch gait, Gait Posture, 2012, Vol. 35, 556–560.
- [21] SUZUKI N., SHINOHARA T., KIMIZUKA M., YAMAGUCHI K., MITA K., Energy expenditure of diplegic ambulation using flexible plastic ankle foot orthoses, Bull Hosp. Jt Dis., 2000, Vol. 59(2), 76–80.
- [22] TEDROFF K., KNUTSON L.M., SODERBERG G.L., Synergistic muscle activation during maximum voluntary contractions in children with and without spastic cerebral palsy, Dev. Med. Child Neurol., 2006, Vol. 48, 789–796.
- [23] VAN ZWIETEN K.J., NARAIN F., SCHMIDT K., “Paradoxical increase” of pacing frequency (Hz) in early Multiple Sclerosis (MS) patients is unraveled by clinical observation, focusing on gait analysis, ISVD, 2011, Vol. 12(6), 9–10.
- [24] WHITE H., JENKINS J., NEACE W.P., TYLKOWSKI C., WALKER J., Clinically prescribed orthroses demonstrate an increase in velocity of gait in children with cerebral palsy: a retrospective study, Dev. Med. Child Neurol., 2002, Vol. 44(4), 227–232.
Uwagi
PL
Opracowanie ze środków MNiSW w ramach umowy 812/P-DUN/2016 na działalność upowszechniającą naukę.
Typ dokumentu
Bibliografia
Identyfikator YADDA
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