Влияние отводящего ортеза на кинематические показатели тазобедренного сустава при ходьбе у детей со спастическими формами ДЦП

Abstract

Introduction Adduction or flexion-adduction contracture of the hip joint often causes static and dynamic impairments in children with spastic cerebral palsy that can be corrected with hip abduction orthosis. No reports confirming or rejecting the effectiveness of the method in the gait correction have not found. The objective was to explore the effect of the hip abduction orthosis on gait kinematics in children with spastic cerebral palsy. Material and methods Twelve biomechanical tests were performed for 6 patients of GMFCS level 3 (6 tests with hip abduction orthosis and 6 tests with no hip abduction orthosis). Gait analysis was produced using the Qualisys Miqus M5 motion capture system (Sweden). Clinical gait analysis was performed with PAF 2.0 of QTM software, Visual3D, Statistica 10 and Excel. Results A comparative analysis of the mean values showed differences in the gait parameters depending on test conditions. Improvements in the spatial-temporal parameters ranged between 0.4 % and 23.6 % with use of orthosis. The kinematic analysis of large joints demonstrated a slight positive effect on the hip joint function. There were no significant differences in the function of other joints. The use of orthosis improved the overall gait index score for the left and right lower limbs by 12.5 % and 5.7 %, respectively. A detailed analysis of the gait index for large joints of the lower limbs demonstrated the discrete improvement. Conclusion Hip abduction orthosis showed a positive effect on the gait pattern of children with spastic cerebral palsy.