背景:铰链式踝足矫形器(HAFO)通常用于脑瘫(CP)儿童,以改善其步行功能。
目的:本研究的目的是比较振动-HAFO与无振动的相同矫形器对步态的影响,函数,偏瘫CP儿童痉挛。
方法:随机对照试验设计(初步研究)。
方法:23名患有偏瘫性CP的儿童参与了这项研究。对照组(n=12)使用HAFO,干预组(n=11)使用振动-HAFO治疗4周。进行前后三维步态分析。还测量了小腿肌肉痉挛和功能。
结果:结果显示,在一分钟步行测试(p=0.023)和痉挛状态(干预后[p=0.022],两组之间存在显着差异,随访后[p=0.020])。此外,两组之间的步宽存在显着差异(p=0.042),最大髋关节外展(p=0.008),赤足状态下的姿势最大背屈(p=0.036)和平均骨盆倾斜(p=0.004)。步态周期时间(p=0.005),最大髋关节外展(p=0.042),在支撑条件下,两组之间的节奏不同(p=0.001)。我们无法发现膝关节运动学参数在组内和组间的任何显著差异。使用振动的平均时间为每天16.83分钟。
结论:振动铰链式AFO是可行的,安全,对于偏瘫CP患儿来说,可以接受。时空和临床参数,尤其是痉挛,改进了。骨盆和膝关节运动学有轻微改善的趋势。振动-HAFO对轻度和中度痉挛的卧床CP儿童有益。它提高了孩子们的步行能力。
BACKGROUND: Hinged ankle foot orthoses (HAFO) are commonly prescribed for children with cerebral palsy (CP) to improve their ambulatory function.
OBJECTIVE: The aim of this study was to compare the effect of vibration-HAFO with that of the same orthosis without vibration on gait, function, and spasticity in hemiplegic CP children.
METHODS: Randomized Control Trial Design (a pilot study).
METHODS: Twenty-three children with hemiplegic CP participated in this study. The control group (n = 12) used HAFO, and the intervention group (n = 11) used vibration-HAFO for four weeks. Pre-post three-dimensional gait analysis was done. Calf muscle spasticity and function were also measured.
RESULTS: Results showed significant differences between the two groups in the one-minute walking test (p = 0.023) and spasticity (after intervention [p = 0.022], after follow-up [p = 0.020]). Also, significant differences were detected between the two groups in the step width (p = 0.042), maximum hip abduction (p = 0.008), stance maximum dorsiflexion (p = 0.036) and mean pelvic tilt (p = 0.004) in the barefoot condition. Gait cycle time (p = 0.005), maximum hip abduction (p = 0.042), and cadence (p = 0.001) were different between groups in the braced condition. We couldn\'t find any significant within and between groups differences in knee kinematic parameters. The mean time of using vibration was 16.83 minutes per day.
CONCLUSIONS: The vibration-hinged AFO is feasible, safe, and acceptable for children with hemiplegic CP to be integrated into practice. Temporospatial and clinical parameters, especially spasticity, were improved. There were slight trends toward improvement in pelvic and knee kinematics. Vibration-HAFO is of benefit to ambulatory CP children with mild and moderate spasticity. It improved the walking capacity of the children.