RESUMEN
PURPOSE: To perform a literature review evaluating the quality of current research on the influence of ankle-foot orthoses (AFOs) on gait in children with cerebral palsy (CP). METHODS: A qualitative systematic review of intervention studies including the following words/phrases in the title/abstract: children with CP, AFO, gait and inferential statistical analysis, and outcomes related to gait. Databases searched included PubMed, Cochrane Library, PEDro, OTSeeker, Lilacs, and Scielo. Level of evidence was graded using the PEDro Scale. RESULTS: Two between-group and 18 within-group studies met the inclusion criteria indicating a low level of evidence. Between-group studies each scored 4 on the PEDro Scale, and 17 within-group studies scored 3 and 1 scored 2, indicating low quality. Standard terminology for AFOs was not used and only 6 studies described functional status using appropriate instruments. CONCLUSIONS: Studies using high quality methods are still needed to support evidence-based decisions regarding the use of AFOs for this population.
Asunto(s)
Parálisis Cerebral/terapia , Marcha , Aparatos Ortopédicos , Adolescente , Articulación del Tobillo/fisiología , Niño , Preescolar , Pie Equino/prevención & control , Femenino , Pie , Marcha/fisiología , Humanos , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del TratamientoRESUMEN
BACKGROUND AND PURPOSE: The atypical walking pattern in children with spastic cerebral palsy is assumed to involve kinematic and morphological adaptations that allow them to move. The purpose of this study was to explore how the requirements of the task and the energy-generating and energy-conserving capabilities of children with cerebral palsy relate to kinematic and mechanical energy patterns of walking. SUBJECTS: Six children with hemiplegic cerebral palsy and a matched group of typically developing children participated in the study. METHODS: Kinematic data were collected at 5 different walking speeds. Vertical stiffness, mechanical energy parameters, and landing angle were measured during the stance phase. RESULTS: The affected side of the children with cerebral palsy showed greater vertical stiffness, a greater ratio of kinetic forward energy to potential energy, and a smaller landing angle when compared with those of the nonaffected lower extremity and with those of typically developing children. DISCUSSION AND CONCLUSION: Previous research has shown that children with cerebral palsy assumed a gait similar to an inverted pendulum on the nonaffected limb and a pogo stick on the affected limb. Our results indicate that asymmetries between lower extremities and differences from typically developing children in the landing angle of the lower extremity, vertical lower-extremity stiffness, and kinetic and potential energy profiles support the claim that walking patterns in children with spastic hemiplegic cerebral palsy emerge as a function of the resources available to them.