Effect of ankle-foot orthoses on trunk sway and lower limb intersegmental coordination in children with bilateral cerebral palsy

Article type: Research Article

Authors: Degelean, Marc^; | De Borre, Ludo^; | Salvia, Patrick | Pelc, Karine | Kerckhofs, Eric | De Meirleir, Linda | Cheron, Guy | Dan, Bernard^{; ;}

Affiliations: Centre d'Analyse du Mouvement, Hôpital Brugmann, Université Libre de Bruxelles, Brussels, Belgium | Ziekenhuis Inkendaal, Vlezenbeek, Belgium | Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium | Laboratory of Neurophysiology and Movement Biomechanics, Université Libre de Bruxelles, Brussels, Belgium | Department of Rehabilitation Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium | Universitair Ziekenhuis Vrije Universiteit Brussel, Brussels, Belgium

Note: [] Corresponding author: Prof. B. Dan, Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), 15 Avenue JJ Crocq, 1020 Brussels, Belgium. Fax: +32 2 4772860; E-mail: [email protected]

Abstract: Introduction: Ankle-foot orthoses may significantly improve lower limb kinematics in the gait of children with cerebral palsy. Here we aimed to analyze the effect of ankle-foot orthoses on trunk postural control and lower limb intersegmental coordination in children with mild spastic diplegia (GMFCS I or II). Methods: We recorded tridimensional trunk kinematics and thigh, shank, and foot elevation angles in 20 4–12 year-old children born preterm with spastic diplegia and 20 typically developing children while walking either barefoot or with ankle-foot orthoses. Results: We found significantly greater trunk excursions in children with cerebral palsy compared to typically developing children in both conditions. When wearing ankle-foot orthoses cerebral palsy children showed increased trunk frontal angular velocity. No significant changes in trunk displacement and angular velocity were recorded in the sagittal plane in either group. Typically developing children wearing orthoses showed increased trunk frontal displacement. Wearing orthoses induced significant changes in shank and foot elevation in both groups. Conclusion: Ankle-foot orthoses affect postural control and intersegmental coordination in children with cerebral palsy. This should be taken into account when planning therapeutic management.

Keywords: Gait, postural control, ankle-foot orthoses, cerebral palsy

DOI: 10.3233/PRM-2012-0209

Journal: Journal of Pediatric Rehabilitation Medicine, vol. 5, no. 3, pp. 171-179, 2012