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The influence of the use of ankle-foot orthoses on thorax, spine, and pelvis kinematics during walking in children with cerebral palsy

BACKGROUND: To improve gait function in children with cerebral palsy, ankle-foot
orthoses are often prescribed. However, until now, little attention has been
devoted to the effect of ankle-foot orthoses on the postural control during
walking in children with cerebral palsy. OBJECTIVES:
The aim was to compare the
differences in thorax, spine, and pelvis movements in children with cerebral
palsy during walking barefoot and walking with ankle-foot orthoses. STUDY DESIGN:
Clinical study with an intra subject design. METHODS:
A total of 15 children (12
boys and 3 girls; mean age, 8 +/- 2 years) with bilateral spastic cerebral palsy
(12 with Gross Motor Function Classification System I and 3 with Gross Motor
Function Classification System II) performed a full-body three-dimensional gait
analysis. Differences in the range of motion of the thorax, spine, and pelvis
during walking barefoot and walking with bilateral ankle-foot orthoses were
analyzed (SPSS v20, paired-samples t-test). RESULTS: Children with cerebral palsy
showed a significantly larger range of motion of the thorax (flexion/extension,
lateral bending, and rotation) and the spine (lateral bending) during walking
with ankle-foot orthoses compared to walking barefoot. No significant differences
were found in the range of motion of the pelvis between these two conditions.
CONCLUSION: It can be concluded that wearing ankle-foot orthoses influences the
postural control during walking in children with bilateral spastic cerebral
palsy. Due to the increased range of motions, the movement pattern of the trunk
diverges from the typically developing children. Clinical relevance Wearing
ankle-foot orthoses not only gives more stability at the pelvis and ankle joint
but also influences trunk motion. In order of the level of core stability of the
child, compensations can be either seen in the lower back or the upper trunk.
Clinicians should be aware of these compensations and should evaluate postural
control in a more detailed evaluation.

Langue : ANGLAIS

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