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orthotics cerebral palsy

Amy F Bailes, Cailee Caldwell, Mike Clay, Melissa Tremper, Kari Dunning, Jason Long
PURPOSE: To evaluate the immediate orthotic, total and therapeutic effects of functional electrical stimulation (FES) neuroprosthesis use on clinic based measures of gait and function in children with hemiplegic cerebral palsy. METHODS: Eleven children (mean 9 years 11 months) participated in an FES neuroprosthesis (Ness L300) intervention (4 week accommodation period followed by 12 weeks of daily use) and were assessed at baseline and post in stimulation off and stimulation on conditions...
September 16, 2016: Disability and Rehabilitation
Hwan Choi, Tishya Anne Leong Wren, Katherine Muterspaugh Steele
BACKGROUND: Many individuals with cerebral palsy wear ankle foot orthoses during daily life. Orthoses influence joint motion, but how they impact muscle remains unclear. In particular, the gastrocnemius is commonly stiff in cerebral palsy. Understanding whether orthoses stretch or shorten this muscle during daily life may inform orthosis design and rehabilitation. OBJECTIVES: This study investigated the impact of different ankle foot orthoses on gastrocnemius operating length during walking in children with cerebral palsy...
September 9, 2016: Prosthetics and Orthotics International
S T J Tsang, D McMorran, L Robinson, J Herman, J E Robb, M S Gaston
The aim of this study was to evaluate the outcome of combined tibialis anterior tendon shortening (TATS) and calf muscle-tendon lengthening (CMTL) in spastic equinus. Prospectively collected data was analysed in 26 patients with hemiplegic (n=13) and diplegic (n=13) cerebral palsy (CP) (GMFCS level I or II, 14 males, 12 females, age range 10-35 years; mean 16.8 years). All patients had pre-operative 3D gait analysis and a further analysis at a mean of 17.1 months (±5.6months) after surgery. None was lost to follow-up...
August 17, 2016: Gait & Posture
Stefan Schmid, Jacqueline Romkes, William R Taylor, Silvio Lorenzetti, Reinald Brunner
BACKGROUND AND PURPOSE: Foot equinus and leg length discrepancy (LLD) are common problems in hemiplegic cerebral palsy (hCP), both causing secondary deviations of pelvic motion during gait. It can therefore be assumed that the spinal deviations observed in hCP patients are secondary as a compensation for the position of the pelvis arising from the disturbed leg function. This study investigated the effects of correcting lower extremity function by orthotics on spinal gait kinematics in hCP patients...
September 2016: Gait & Posture
Christelle Pons, Sylvain Brochard, Philippe Gallien, Benoit Nicolas, Aurélie Duruflé, Marion Roquet, Olivier Rémy-Néris, Ronan Garlantezec
OBJECTIVE: To evaluate medication, rehabilitation and healthcare consumption in adults with CP as a function of Gross Motor Function Classification System (GMFCS) level. DESIGN: Questionnaire-based cross-sectional study. SETTING: Brittany, a French county. SUBJECTS: Adults with cerebral palsy. INTERVENTIONS: Questionnaires relating to drugs, orthotic devices, mobility aids, rehabilitation and medical input were sent to 435 members of a unique regional French network dedicated to adults with cerebral palsy...
August 9, 2016: Clinical Rehabilitation
Lizeth H Sloot, Lynn Bar-On, Marjolein M van der Krogt, Erwin Aertbeliën, Annemieke I Buizer, Kaat Desloovere, Jaap Harlaar
AIM: We compared the outcomes of manual and motorized instrumented ankle spasticity assessments in children with cerebral palsy (CP). METHOD: Ten children with spastic CP (three males, seven females; mean age 11y [standard deviation 3y], range 6-14y; Gross Motor Function Classification System levels I-III) were included. During motorized assessments, fast (100°/s) rotations were imposed around the ankle joint by a motor-driven footplate; during manual assessments, rotations of comparable speed were applied by a therapist using a foot orthotic...
July 1, 2016: Developmental Medicine and Child Neurology
Vito Pavone, Gianluca Testa, Domenico A Restivo, Luca Cannavò, Giuseppe Condorelli, Nicola M Portinaro, Giuseppe Sessa
CP is the most common cause of chronic disability in childhood occurring in 2-2.5/1000 births. It is a severe disorder and a significant number of patients present cognitive delay and difficulty in walking. The use of botulinum toxin (BTX) has become a popular treatment for CP especially for spastic and dystonic muscles while avoiding deformity and pain. Moreover, the combination of physiotherapy, casting, orthotics and injection of BTX may delay or decrease the need for surgical intervention while reserving single-event, multi-level surgery for fixed musculotendinous contractures and bony deformities in older children...
2016: Frontiers in Pharmacology
Helle Mätzke Rasmussen, Niels Wisbech Pedersen, Søren Overgaard, Lars Kjaersgaard Hansen, Ulrike Dunkhase-Heinl, Yanko Petkov, Vilhelm Engell, Richard Baker, Anders Holsgaard-Larsen
BACKGROUND: Children with cerebral palsy (CP) often have an altered gait. Orthopaedic surgery, spasticity management, physical therapy and orthotics are used to improve the gait. Interventions are individually tailored and are planned on the basis of clinical examinations and standardised measurements to assess walking ('care as usual'). However, these measurements do not describe features in the gait that reflect underlying neuro-musculoskeletal impairments. This can be done with 3-dimensional instrumented gait analysis (IGA)...
2015: BMC Pediatrics
Mara S Karamitopoulos, Lana Nirenstein
Foot and ankle deformities in cerebral palsy can be effectively treated with surgery. Surgery should be considered in patients with significant deformity and those who have pain or difficulty with orthotic and shoe wear. Equinus contracture of both gastrocnemius and soleus can be treated with open tendoachilles lengthening; ankle valgus with medial epiphysiodesis. Equinovarus is more commonly seen in hemiplegic patients and this deformity can usually be treated with tendon transfers. Triple arthrodesis is an option in children with severe degenerative changes...
December 2015: Foot and Ankle Clinics
Dayna Pool, Jane Valentine, Natasha Bear, Cyril J Donnelly, Catherine Elliott, Katherine Stannage
BACKGROUND: The purpose of this study was to determine the orthotic and therapeutic effects of daily community applied FES to the ankle dorsiflexors in a randomized controlled trial. We hypothesized that children receiving the eight-week FES treatment would demonstrate orthotic and therapeutic effects in gait and spasticity as well as better community mobility and balance skills compared to controls not receiving FES. METHODS: This randomized controlled trial involved 32 children (mean age 10 yrs 3 mo, SD 3 yrs 3 mo; 15 females, 17 males) with unilateral spastic cerebral palsy and a Gross Motor Function Classification System of I or II randomly assigned to a FES treatment group (n = 16) or control group (n = 16)...
2015: BMC Pediatrics
S Pérez-de la Cruz
INTRODUCTION: One of the consequences of poor postural control in children with cerebral palsy is hip dislocation. This is due to the lack of weight-bearing in the sitting and standing positions. Orthotic aids can be used to prevent onset and/or progression. OBJECTIVE: The aim of this study is to analyse the effectiveness of positioning systems in achieving postural control in patients with cerebral palsy, and discuss these findings with an emphasis on what may be of interest in the field of neurology...
August 20, 2015: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Tishya A L Wren, James W Dryden, Nicole M Mueske, Sandra W Dennis, Bitte S Healy, Susan A Rethlefsen
PURPOSE: To compare dynamic ankle-foot orthoses (DAFOs) and adjustable dynamic response (ADR) ankle-foot orthoses (AFOs) in children with cerebral palsy. METHODS: A total of 10 children with cerebral palsy (4-12 years; 6 at Gross Motor Function Classification System level I, 4 at Gross Motor Function Classification System level III) and crouch and/or equinus gait wore DAFOs and ADR-AFOs, each for 4 weeks, in randomized order. Laboratory-based gait analysis, walking activity monitor, and parent-reported questionnaire outcomes were compared among braces and barefoot conditions...
2015: Pediatric Physical Therapy
Allan M Glanzman, Julie Cort
No abstract text is available yet for this article.
2015: Pediatric Physical Therapy
Sam Khamis, Raz Martikaro, Shlomo Wientroub, Yoram Hemo, Shlomo Hayek
BACKGROUND: Crouch gait is a major sagittal plane deviation in children diagnosed with cerebral palsy (CP). It is defined as a combination of excessive ankle dorsiflexion and knee and hip flexion throughout the stance phase. To the best of our knowledge, functional electrical stimulation (FES) has not been used to decrease the severity of crouch gait in CP subjects and assist in achieving lower limb extension. PURPOSE: To evaluate the short- and long-term effects of FES to the quadriceps muscles in preventing crouch gait and achieving ankle plantar flexion, knee and hip extension at the stance phase...
April 2015: Journal of Children's Orthopaedics
Jenny M Frances, David S Feldman
Flatfoot in a child may be normal before development of the arch, but the prevalence decreases with age. Treatment is indicated only in the presence of pain and should begin with nonsurgical management options such as stretching of the Achilles tendon and the use of soft shoe orthotics. If pain persists, a modified Evans procedure, together with additional procedures to address forefoot supination, can be successful in correcting deformity and addressing pain. A thorough understanding of the pathology and correction desired will help minimize complications and recurrence...
2015: Instructional Course Lectures
Devon Holley, Michelle Johnson, Gerald Harris, Scott Beardsley
Children with Cerebral Palsy (CP) often exhibit impairments in the coordination of the grip and lift phases of arm movements that directly impact their ability to perform activities of daily living (ADLs). The application of assistive robotic therapy to children with spastic hemiplegic CP has shown that augmented movement training can lead to improved functional outcomes and improved arm kinematics. Assistive robotic therapy of the wrist has been shown to help improve motor skills in stroke patients, but the devices employed are often large and obtrusive, focusing on a repeated motion rather than a task-based itinerary...
2014: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Paz Kedem, David M Scher
PURPOSE OF REVIEW: The present article describes common foot deformities in children with cerebral palsy and discusses treatment options for each of those deformities. RECENT FINDINGS: Bracing is a useful treatment to correct foot deformities during gait. Surgical correction of foot deformities is typically performed as a part of multilevel single-event gait improvement surgery that has increasingly become the standard of care for ambulatory children with cerebral palsy...
February 2015: Current Opinion in Pediatrics
Angeline Nsenga Leunkeu, Thierry Lelard, Roy J Shephard, Pierre-Louis Doutrellot, Said Ahmaidi
BACKGROUND: Information on altered foot pressures during ambulation would clarify how far limb deformities modify walking patterns in cerebral palsy (CP), and whether such data can inform prognosis and guide rehabilitation. OBJECTIVE: To compare patterns of plantar pressures during walking between children with CP and their able-bodied (AB) peers. METHODS: Twenty-five children/adolescents (10 with hemiplegia, 5 with diplegia, and 10 AB, respective ages 13...
2014: NeuroRehabilitation
M Ferrarin, M Rabuffetti, M Bacchini, A Casiraghi, A Castagna, A Pizzi, A Montesano
BACKGROUND: Gait analysis (GA) was demonstrated to change presurgical planning and improve gait outcomes in children with Cerebral Palsy. GA is often used also to assess walking capability of poststroke subjects, although its influence in the clinical management of these patients has not yet been established. OBJECTIVE: To assess the impact of GA on clinical decision-making in adult chronic poststroke patients. DESIGN: Pragmatic prospective observational study...
April 2015: European Journal of Physical and Rehabilitation Medicine
Jc Maas, Aj Dallmeijer, Pa Huijing, Je Brunstrom-Hernandez, Pj van Kampen, Eam Bolster, C Dunn, K Herndon, Rt Jaspers, Jg Becher
OBJECTIVE: To examine whether using a knee-ankle-foot orthosis helps maintain ankle-foot dorsiflexion range of motion over time. DESIGN: A multicentre randomized controlled trial. SETTING: Two hospitals and one rehabilitation centre in the Netherlands and the USA. SUBJECTS: Children (4-16 years old) with spastic cerebral palsy who were able to walk. INTERVENTION: Use of a knee-ankle-foot orthosis, equipped with an Ultraflex ankle power unit, for at least 6 hours every other night for one year...
October 2014: Clinical Rehabilitation
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