Abstract
BackgroundWalking aids and ankle–foot orthoses (AFOs) are designed to address gait problems. These devices are common among children with cerebral palsy (CP), as those children’s ability to ambulate is a big concern for their parents, and its improvement is considered primary focus of therapeutic modalities addressing motor disorders of this population. However, empirical support for walking aids and AFO is limited. The aim of this review was to assess the quality of research on the effect of walking aids and AFO on energy expenditure in children with CP.Materials and methodsFour electronic databases using predefined terms were searched by two independent reviewers. All study designs except case reports were included. Nineteen studies involving 509 participants met inclusion criteria and were involved in this review.ResultsHeterogeneity was observed across included studies in measurement, implementation, and study rigor.ConclusionThere is a need for high-quality studies to draw a clear conclusion on the effect of walking aids and AFO on energy expenditure in children with CP; the typical flaws of existing studies included weak experimental designs, insubstantial treatment outcomes, and high risk of bias.
Highlights
Cerebral palsy (CP) is a familiar cause of postural and movement disorders among children, which are caused by damage of immature brain
PCI was lower with ankle–foot orthoses (AFOs) than without AFO PCI for spastic diplegic children with and without AFOs is higher than PCI for normal children (P
All VAFOs decreased the knee flexion angle at contralateral toe-off, midstance, and timing of KEpk (P=0.025) Ankle power generation and work were preserved only by the spring-like VAFOs All VAFOs decreased the net energy cost compared with shoes-only, but no differences were found between VAFOs It was found that plastic orthoses ensured energy efficiency during walking, and this effect was most significant in patients using solid PAFOs (P=0.008)
Summary
Cerebral palsy (CP) is a familiar cause of postural and movement disorders among children, which are caused by damage of immature brain. Joint deformities and muscle contractures occur in response to musculoskeletal growth and primary impairments and are termed as secondary impairments. All of these impairments allow children with CP to walk with inefficient pattern [1]. Walking aids and ankle–foot orthoses (AFOs) are designed to address gait problems. These devices are common among children with cerebral palsy (CP), as those children’s ability to ambulate is a big concern for their parents, and its improvement is considered primary focus of therapeutic modalities addressing motor disorders of this population. Nineteen studies involving 509 participants met inclusion criteria and were involved in this review
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