Category: Pediatric Rehabilitation; Geriatric Rehabilitation
Objective : Bone deformities, the result of abnormal loading, are common in children with spastic hemiplegic cerebral palsy (SHCP). Although the purpose of ankle-foot-orthosis (AFO) is to account for loading abnormalities, little is known about the loading patterns of the uninvolved lower extremity (LE). The purpose, therefore, of this study was to investigate the loading patterns of the uninvolved hip in children with SHCP by comparing braced and un-braced conditions.
Design : Retrospective, intervention study
Setting : Our hospital's Motion Analysis laboratory
Participants (or Animals, Specimens, Cadavers) : 16 children with SHCP, 6-18 years of age (average 9 years old), GMFCS I-II. Subjects were excluded if they had undergone surgery within 6 months from the time of data collection or if they were using any other ambulatory device. No participant had history of other neuromusculoskeletal diagnosis.
Interventions : Subjects underwent three-dimensional gait analysis. Each walked at self-selected pace, barefoot and with their prescribed AFO on the involved LE.
Main Outcome Measure(s) : Maximum anterior/posterior forces and transverse plane moments at the involved and uninvolved hips, along with the respective timings, were calculated. All data were normalized. Timing was expressed as percent of the gait cycle. Forces and moments were expressed relative to the subject's body weight.
Results : Forces were not statistically different between the involved and uninvolved hips when walking with the AFO. Posterior forces at the involved hip increased when walking with the AFO compared to barefoot (p=0.01). The same was true for the moments.
Conclusions : This is, to our knowledge, the first study investigating the loading effects on the uninvolved hip as a function of walking with and without an AFO. The results demonstrate symmetrical loading of the involved and uninvolved hips when walking with the AFO.