The effect of vibration-hinged ankle foot orthoses on gait and spasticity in children with cerebral palsy: A randomized clinical trial design.
Humans
Cerebral Palsy
/ complications
Child
Male
Muscle Spasticity
/ etiology
Female
Vibration
/ therapeutic use
Foot Orthoses
Pilot Projects
Gait Disorders, Neurologic
/ rehabilitation
Gait
/ physiology
Equipment Design
Hemiplegia
/ rehabilitation
Treatment Outcome
Adolescent
Ankle Joint
/ physiopathology
Biomechanical Phenomena
Journal
Prosthetics and orthotics international
ISSN: 1746-1553
Titre abrégé: Prosthet Orthot Int
Pays: France
ID NLM: 7707720
Informations de publication
Date de publication:
01 Aug 2024
01 Aug 2024
Historique:
received:
13
01
2023
accepted:
09
06
2023
medline:
14
8
2024
pubmed:
14
8
2024
entrez:
14
8
2024
Statut:
ppublish
Résumé
Hinged ankle foot orthoses (HAFO) are commonly prescribed for children with cerebral palsy (CP) to improve their ambulatory function. The aim of this study was to compare the effect of vibration-HAFO with that of the same orthosis without vibration on gait, function, and spasticity in hemiplegic CP children. Randomized Control Trial Design (a pilot study). Twenty-three children with hemiplegic CP participated in this study. The control group (n = 12) used HAFO, and the intervention group (n = 11) used vibration-HAFO for four weeks. Pre-post three-dimensional gait analysis was done. Calf muscle spasticity and function were also measured. Results showed significant differences between the two groups in the one-minute walking test (p = 0.023) and spasticity (after intervention [p = 0.022], after follow-up [p = 0.020]). Also, significant differences were detected between the two groups in the step width (p = 0.042), maximum hip abduction (p = 0.008), stance maximum dorsiflexion (p = 0.036) and mean pelvic tilt (p = 0.004) in the barefoot condition. Gait cycle time (p = 0.005), maximum hip abduction (p = 0.042), and cadence (p = 0.001) were different between groups in the braced condition. We couldn't find any significant within and between groups differences in knee kinematic parameters. The mean time of using vibration was 16.83 minutes per day. The vibration-hinged AFO is feasible, safe, and acceptable for children with hemiplegic CP to be integrated into practice. Temporospatial and clinical parameters, especially spasticity, were improved. There were slight trends toward improvement in pelvic and knee kinematics. Vibration-HAFO is of benefit to ambulatory CP children with mild and moderate spasticity. It improved the walking capacity of the children.
Sections du résumé
BACKGROUND
BACKGROUND
Hinged ankle foot orthoses (HAFO) are commonly prescribed for children with cerebral palsy (CP) to improve their ambulatory function.
OBJECTIVES
OBJECTIVE
The aim of this study was to compare the effect of vibration-HAFO with that of the same orthosis without vibration on gait, function, and spasticity in hemiplegic CP children.
STUDY DESIGN
METHODS
Randomized Control Trial Design (a pilot study).
METHODS
METHODS
Twenty-three children with hemiplegic CP participated in this study. The control group (n = 12) used HAFO, and the intervention group (n = 11) used vibration-HAFO for four weeks. Pre-post three-dimensional gait analysis was done. Calf muscle spasticity and function were also measured.
RESULTS
RESULTS
Results showed significant differences between the two groups in the one-minute walking test (p = 0.023) and spasticity (after intervention [p = 0.022], after follow-up [p = 0.020]). Also, significant differences were detected between the two groups in the step width (p = 0.042), maximum hip abduction (p = 0.008), stance maximum dorsiflexion (p = 0.036) and mean pelvic tilt (p = 0.004) in the barefoot condition. Gait cycle time (p = 0.005), maximum hip abduction (p = 0.042), and cadence (p = 0.001) were different between groups in the braced condition. We couldn't find any significant within and between groups differences in knee kinematic parameters. The mean time of using vibration was 16.83 minutes per day.
CONCLUSIONS
CONCLUSIONS
The vibration-hinged AFO is feasible, safe, and acceptable for children with hemiplegic CP to be integrated into practice. Temporospatial and clinical parameters, especially spasticity, were improved. There were slight trends toward improvement in pelvic and knee kinematics. Vibration-HAFO is of benefit to ambulatory CP children with mild and moderate spasticity. It improved the walking capacity of the children.
Identifiants
pubmed: 39140761
doi: 10.1097/PXR.0000000000000266
pii: 00006479-202408000-00005
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
387-399Informations de copyright
Copyright © 2023 International Society for Prosthetics and Orthotics.
Références
Morris C. Definition and classification of cerebral palsy: a historical perspective. Dev Med Child Neurol 2007; 49: 3–7.
Lundy C, Lumsden D, Fairhurst C. Treating complex movement disorders in children with cerebral palsy. Ulster Med J 2009; 78: 157.
Wren TA, Rethlefsen S, Kay RM. Prevalence of specific gait abnormalities in children with cerebral palsy: influence of cerebral palsy subtype, age, and previous surgery. J Pediatr Orthop 2005; 25: 79-83.
Lintanf M, Bourseul JS, Houx L, et al. Effect of ankle-foot orthoses on gait, balance and gross motor function in children with cerebral palsy: a systematic review and meta-analysis. Clin Rehabil 2018; 32: 1175–1188.
Pedretti LW, Early MB. Occupational Therapy: Practice Skills for Physical Dysfunction. St. Louis, MO: Mosby; 2001.
Lopez S, Bini F, Del Percio C, et al. Electroencephalographic sensorimotor rhythms are modulated in the acute phase following focal vibration in healthy subjects. Neuroscience 2017; 352: 236–248.
Celletti C, Camerota F. Preliminary evidence of focal muscle vibration effects on spasticity due to cerebral palsy in a small sample of Italian children. Clin Ter 2011; 162: e125–e128.
Ruck J, Chabot G, Rauch F. Vibration treatment in cerebral palsy: a randomized controlled pilot study. J Musculoskelet Neuronal Interact 2010; 10: 77–83.
Lee B-K, Chon S-C. Effect of whole body vibration training on mobility in children with cerebral palsy: a randomized controlled experimenter-blinded study. Clin Rehabil 2013; 27: 599–607.
Schirinzi T, Romano A, Favetta M, et al. Non-invasive focal mechanical vibrations delivered by wearable devices: an open-label pilot study in childhood Ataxia. Front Neurol 2018; 9: 849.
Ridding M, Brouwer B, Miles T, et al. Changes in muscle responses to stimulation of the motor cortex induced by peripheral nerve stimulation in human subjects. Exp Brain Res 2000; 131: 135–143.
Kawahira K, Shimodozono M, Etoh S, et al. New facilitation exercise using the vestibulo-ocular reflex for ophthalmoplegia: preliminary report. Clin Rehabil 2005; 19: 627–634.
Julious SA. Sample size of 12 per group rule of thumb for a pilot study. Pharmaceut Stat 2005; 4: 287–291.
Schweizer K, Brunner R, Romkes J. Upper body movements in children with hemiplegic cerebral palsy walking with and without an ankle–foot orthosis. Clin Biomech 2014; 29: 387–394.
White H, Jenkins J, Neace WP, et al. Clinically prescribed orthoses demonstrate an increase in velocity of gait in children with cerebral palsy: a retrospective study. Dev Med Child Neurol 2002; 44: 227–232.
Park JM, Lim HS, Song CH. The effect of external cues with vibratory stimulation on spatiotemporal gait parameters in chronic stroke patients. J Phys Ther Sci 2015; 27: 377–381.
Mutlu A, Livanelioglu A, Gunel MK. Reliability of Ashworth and modified Ashworth scales in children with spastic cerebral palsy. BMC Musculoskelet Disord 2008; 9: 44.
Pin TW, Butler PB, Purves S. Use of whole body vibration therapy in individuals with moderate severity of cerebral palsy—a feasibility study. BMC Neurol 2019; 19: 80.
Romkes J, Brunner R. Comparison of a dynamic and a hinged ankle–foot orthosis by gait analysis in patients with hemiplegic cerebral palsy. Gait Posture 2002; 15: 18–24.
Wren TA, Do KP, Hara R, et al. Gillette Gait Index as a gait analysis summary measure: comparison with qualitative visual assessments of overall gait. J Pediatr Orthop 2007; 27: 765–768.
McDowell BC, Humphreys L, Kerr C, et al. Test–retest reliability of a 1-min walk test in children with bilateral spastic cerebral palsy (BSCP). Gait Posture 2009; 29: 267–269.
Moradiabbasabadi M, Akbarfahimi N, Hossein A, et al. Content validity of the Persian version of the Pediatric Evaluation of Disability Inventory (PEDI). J Rehabil Sci 2014: 35–45.
Heinemann AW, Bode R, O'reilly C. Development and measurement properties of the Orthotics and Prosthetics Users' Survey (OPUS): a comprehensive set of clinical outcome instruments. Prosthet Orthot Int 2003; 27: 191–206.
Hadadi M, Ghoseiri K, Fardipour S, et al. The Persian version of satisfaction assessment module of Orthotics and Prosthetics Users' Survey. Disabil Health J 2016; 9: 90–99.
Katusic A, Alimovic S, Mejaski-Bosnjak V. The effect of vibration therapy on spasticity and motor function in children with cerebral palsy: a randomized controlled trial. NeuroRehabilitation 2013; 32: 1–8.
Stark C, Herkenrath P, Hollmann H, et al. Early vibration assisted physiotherapy in toddlers with cerebral palsy—a randomized controlled pilot trial. J Musculoskelet Neuronal Interact 2016; 16: 183–192.
Chong J, Mackey AH, Broadbent E, et al. Relationship between walk tests and parental reports of walking abilities in children with cerebral palsy. Arch Phys Med Rehabil 2011; 92: 265–270.
Öztürk B, Uygur F, Yakut Y. Effect of ankle-foot orthoses on functional performance and physiological cost index in children with cerebral palsy. J Exerc Ther Rehabil 2015; 2: 86–92.
Martakis K, Stark C, Rehberg M, et al. One-minute walk test in children with cerebral palsy GMFCS level 1 and 2: reference values to identify therapeutic effects after rehabilitation. Dev Neurorehabil 2020; 23: 201–209.
Balaban B, Yasar E, Dal U, et al. The effect of hinged ankle-foot orthosis on gait and energy expenditure in spastic hemiplegic cerebral palsy. Disabil Rehabil 2007; 29: 139–144.
Totah D, Menon M, Jones-Hershinow C, et al. The impact of ankle-foot orthosis stiffness on gait: a systematic literature review. Gait Posture 2019; 69: 101–111.
Buckon CE, Thomas SS, Jakobson-Huston S, et al. Comparison of three ankle–foot orthosis configurations for children with spastic diplegia. Dev Med Child Neurol 2004; 46: 590–598.
Piccinini L, Cimolin V, Turconi A, et al. Quantification of energy expenditure during gait in children with cerebral palsy. Eura Medicophys 2007; 43:7–12.
Stebbins J, Harrington M, Thompson N, et al. Gait compensations caused by foot deformity in cerebral palsy. Gait Posture 2010; 32: 226–230.
Altschuck N, Bauer C, Nehring I, et al. Efficacy of prefabricated carbon-composite ankle foot orthoses for children with unilateral spastic cerebral palsy exhibiting a drop foot pattern. J Pediatr Rehabil Med 2019; 12: 171–180.