The relationship between the use of orthotics and foot deformity in cerebral palsy

Abstract

Aim: Foot deformities are seen in more than 50% of children with cerebral palsy (CP). These deformities may cause gait deviations and mobility disorders over time. We aimed to examine the relationship between orthosis use, gait disturbances, and foot deformities in patients with cerebral palsy. Here, we aimed to analyze the relationship between orthosis use and foot deformities. 
 Materials and Methods: The study was designed as cross-sectional, descriptive. One hundred and two patients who were admitted to Physical Medicine and Rehabilitation Health Care Committee were included. All patients were questioned about their age, birth history, maternal education level, orthosis use, surgery, and botulism toxin application. 
 Detailed neurological examination of all participants (including walking analysis and spasticity) was performed by the same experienced physiatrist.
 
 Results: A total of 102 patients (41 males/61 females; mean age 10.1 ± 6.8 years) were included in the study. The most common type of CP was spastic tetraparesis (37.3%). Most commonly, crouch gait was observed in 23.5% of the patients. 
 The rate of orthosis use in the lower extremity was 21.6%. The median duration of the use was 60 min/day, and the most frequent orthosis type was knee ankle foot orthosis (6.9%). Foot deformities were found in 84.3% of the patients (29.4%), and the most common foot deformity type was equinovarus. Also, 15.7% of the patients had botulism toxin application, and 9.8% had surgery. Foot deformity was observed less frequently in orthosis users (P= 0.042). Foot deformity was observed in 54.5% (n = 12) of the patients using orthosis. A negative correlation was found between spasticity score and ambulation (P= 0.00).
 
 Conclusion: Foot deformities were found high in non daily orthosis use group. With the widespread use of orthosis in children with CP, the development of foot deformities can be prevented.