Effect of ankle foot orthosis on energy expenditure index and gait speed in spastic cerebral palsy children: an observational study

Authors

  • Jumana J. Vanwala S.B.B. College of Physiotherapy, V.S. General Hospital, Ellis Bridge, Ahmedabad-380006, Gujarat, India
  • Shraddha Diwan S.B.B. College of Physiotherapy, V.S. General Hospital, Ellis Bridge, Ahmedabad-380006, Gujarat, India
  • Sweety Shah S.B.B. College of Physiotherapy, V.S. General Hospital, Ellis Bridge, Ahmedabad-380006, Gujarat, India
  • Neeta Vyas S.B.B. College of Physiotherapy, V.S. General Hospital, Ellis Bridge, Ahmedabad-380006, Gujarat, India

Keywords:

Ankle foot orthosis (AFO), Energy expenditure index (EEI), Gait speed, Cerebral palsy

Abstract

Background: Ankle Foot Orthosis (AFO) is a frequently prescribed intervention modality which plays an important role in the management of gait abnormality. The most typical use of AFOs is to optimize the normal dynamics of walking by applying mechanical constraint to the ankle to control motion & at the same time provide more efficient gait. Solid AFOs are most commonly prescribed to reduce excessive plantar flexion in stance & to prevent or eliminate equinus position. So, purpose of this study is to determine whether use of AFO affect the gait speed & energy expenditure in cerebral palsy children or not.

Methods: a convenient sample of 21 subjects diagnosed with spastic cerebral palsy with presence of spasticity of planter flexors (Modified Ashworth Scale <3) with GMFCS level 1, 2 & 3 were included. Informed consent of parents was taken. Children who had undergone surgical correction within 6 month of testing or botulinum toxin injection of spastic planter flexors or any other lower extremity muscle within 3 months were excluded. For 10 meter walk test child was made to walk barefooted then given 10 minute rest & made to walk again for 10 meters with AFO. Their heart rate (Resting & after walking) & time taken for walk were taken each time & energy expenditure index (walking HR-resting HR/distance) & gait speed (distance/time) were calculated.

Results: Mean Energy Expenditure Index (EEI) with barefoot was 158.8 ± 2.37 & with AFO was 370.4 ± 3.93. Speed with barefoot was 0.22 ± 0.16 & with AFO was 0.148 ± 0.18. There was significant difference in gait speed & EEI between the groups & P value was <0.05.

Conclusion: There is increase in EEI & decrease in gait speed in children with spastic cerebral palsy with the use of AFO.

Metrics

Metrics Loading ...

References

Indian Academy of Cerebral Palsy. October 3, 2011 observed as national CP day to raise awareness against the disabling disorders, 2011. Available at: http://www.merinews.com.

Surveillance of Cerebral Palsy in Europe (SCPE). Prevalence & characteristic of children with cerebral palsy in Europe. Dev Med Child Neurol. 2002;44:633-40.

Elyonara M, et al. Efficacy of AFO with cerebral palsy: systemic review of literature. Pediatricphysther. 2008;20:207-33.

Cusick B. An overview of components and concepts involved in orthotic prescription for children with cerebral palsy. In: Meadows CB, Condie DN, eds. Report of a Consensus Conference on the Lower Limb Orthotic Management of Cerebral Palsy. Durhan, N. Carolina: International Society for Prostetic and Orthotics; 1994: 94-122.

Radtka SA, Skinner SR, Johanson ME. A comparison of gait with solid and hinged ankle-foot orthoses in children with spastic diplegic cerebral palsy. Gait Posture. 2005;21:303-10.

Lam WK, Leong JCY, Li YH et al. Biomechanical and electromyo-graphic evaluation of ankle foot orthosis and dynamic ankle foot orthosis in spastic cerebral palsy. Gait Posture. 2005;22:189-97.

Buckon CE, Thomas SS, Huston SJ et al. Comparison of three ankle-foot orthosis configurations for children with spastic diplegia. Dev Med Child Neurol.2004;46:590-8.

Buckon CE, Thomas SS, Huston SJ, et al. Comparison of three ankle-foot orthosis configurations for children with spastic hemiplegia. Dev Med Child Neurol. 2001;43:371-8.

Maltais D, Bar-OrO, Galea V, et al. Use of orthoses lowers the O2 cost of walking in children with spastic cerebral palsy. Med Sci Sports Exerc. 2001;33:320-5.

Smiley SJ, Jacobsen FS, Mielke C, et al. A comparison of the effects of solid, articulated, and posterior leaf-springankle-foot orthoses and shoes alone on gait and energy expenditure in children with spastic diplegic cerebral palsy. Orthopedics. 2002;25:411-5.

Suzuki N, Shinohara T, Kimizuka M, et al. Energy of expenditure of diplegic ambulation using flexible plastic ankle foot orthoses. Bull Hospt Dis. 2000;59:76-80.

Rose J, et al. The energy expenditure index: a method to quantitatate & compare walking energy expenditure for children & adolescent methods. J Pediatr Orthoped. 1991;11:571-8.

Pirpiris M, Wilkinson AJ. Walking speed in children with neuromuscular diseases: a comparison between two assessment methods. J Pediatr Orthoped. 2003;23:302-7.

Figueiredo EM, Ferreira GB, Maia Moreira RC, Kirkwood RN, Fetters L. Efficacy of ankle foot orthosis on energy expenditure & gait in children with cerebral palsy: systematic review of literature. Pediatr Phys Ther. 2008;20(3):207-23.

Assiante C. Development of locomotor balance control in healthy children. Neurosci Biobehav Rev. 1998;22(4):527-32.

Vaughan CL. Theories of bipedal gait: an odyssey. J Biomech. 2003;36:513-23.

Downloads

Published

2017-02-06

How to Cite

Vanwala, J. J., Diwan, S., Shah, S., & Vyas, N. (2017). Effect of ankle foot orthosis on energy expenditure index and gait speed in spastic cerebral palsy children: an observational study. International Journal of Contemporary Pediatrics, 1(1), 17–19. Retrieved from https://www.ijpediatrics.com/index.php/ijcp/article/view/567

Issue

Section

Original Research Articles