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Impact of ankle-foot orthoses on gait 1 year after lower limb surgery in children with bilateral cerebral palsy

Skaaret, Ingrid; Steen, Harald; Terjesen, Terje; Holm, Inger
Journal article, Peer reviewed
Accepted version
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URI
https://hdl.handle.net/10642/6991
Date
2018-08-07
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  • HV - Institutt for rehabiliteringsvitenskap og helseteknologi [469]
Original version
Skaaret I, Steen H, Terjesen T, Holm I. Impact of ankle-foot orthoses on gait 1 year after lower limb surgery in children with bilateral cerebral palsy. Prosthetics and orthotics international . 2018:1-9   http://dx.doi.org/10.1177/0309364618791615
Abstract
Background: Different types of ankle-foot orthoses (AFOs) are commonly used following

lower limb surgery in children with bilateral spastic cerebral palsy (CP). After 3-dimensional

gait analysis one year postoperatively, many children are recommended continued use of

AFOs. Our aims were to quantify the impact of AFOs on gait one year postoperatively and

evaluate predictors for clinically important improvement.

Study design: Prospective cohort study

Methods: Thirty-four ambulating children with bilateral CP, mean age 11 years (range 6-17),

12 girls and 22 boys, were measured with 3-dimensional gait analysis preoperatively

(barefoot) and one year postoperatively (barefoot and with AFOs). Outcome was evaluated

using gait profile score (GPS), key kinematic, kinetic and temporal-spatial variables in paired

sample comparisons. Logistic regression was used to evaluate predictors for clinically

important improvement with orthoses (≥1.6° change in GPS).

Results: Walking barefoot one year postoperatively, major improvements were seen in GPS

and key variables. With AFOs there was significantly improved step length and velocity,

additional moderate reduction/improvement in GPS and knee moments, and decreased stance

ankle dorsiflexion compared to barefoot. Children using ground reaction AFOs (n=14)

decreased stance knee flexion from 13.9° walking barefoot to 8.2° with orthoses. High GPS

and more gait dysfunction preoperatively was a significant predictor of clinically important

improvement walking with orthoses.

Conclusion: The results indicate improved gait function walking with AFOs versus barefoot

one year after lower limb surgery. Stronger impact of AFOs was found in children with more

pronounced gait dysfunction preoperatively.
Publisher
SAGE Publications
Series
Prosthetics and orthotics international;Vol 43, Issue 1, 2019
Journal
Prosthetics and orthotics international

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