The effect of dynamic elastomeric fabric orthosis (DEFO) on sitting balance and gross manual dexterity in children with cerebral palsy: A single-blinded randomized controlled study

Abstract

The aim of this study was to investigate if the use of a vest type dynamic elastomeric fabric orthosis (DEFO) will lead to improvement in sitting balance, hip lateralization and gross manual dexterity. Twenty-four children with CP between the ages of 3–7 with impaired trunk control were allocated to either of three groups: Control group who received only conventional exercise therapy, DEFO 2 hours group who wore DEFO 2 hours during therapy and DEFO 6 hours group who wore DEFO 4 hours in addition to 2 hours of wear during therapy. Children were evaluated with sitting domain of Gross Motor Function Measure (GMFM), Sitting Assessment Scale (SAS), Box and Block Test (BBT) and Parent Satisfaction Questionnaire before treatment (BT), at posttreatment, at 1 month posttreatment (MPT) and at 3 MPT. SAS and BBT were also assessed when immediately after wearing the orthosis. To measure trunk asymmetry and effect of orthosis in hip lateralization, changes in Cobb (CA) and kyphotic angles (KA) and Migration index (MI) between BT and 6 MPT were determined. All groups showed similar improvements except the control group showing less improvement in SAS scores than DEFO groups. SAS and BBT scores also improved immediately after wearing the orthosis. While CA and KA decreased significantly at 6 MPT, MI did not show statistically significant difference. Changes in radiographic assessments were similar between groups except kyphotic angle values. KA values showed less change in control group. When DEFO groups compared with each other, there were no significant differences in any of the assessments. DEFO vest has an immediate effect on sitting balance and gross manual dexterity. DEFO provides improvements in posture and balance during sitting. Using DEFO vest for 2 hours and 6 hours yielded similar outcomes. Wearing DEFO vest improves kyphotic posture but not scoliosis and hip lateralization.