Abstract | OBJECTIVE: To examine whether using a knee-ankle- foot orthosis helps maintain ankle-foot dorsiflexion range of motion over time. DESIGN: A multicentre randomized controlled trial. SETTING: Two hospitals and one rehabilitation centre in the Netherlands and the USA. SUBJECTS: INTERVENTION: Use of a knee-ankle- foot orthosis, equipped with an Ultraflex ankle power unit, for at least 6 hours every other night for one year. MAIN MEASURES: PRIMARY OUTCOME MEASURE: ankle-foot dorsiflexion range of motion. SECONDARY OUTCOME MEASURES: ankle-foot and knee angle in gait and gross motor function. Wearing time was also measured. Measurements were taken at baseline and at 3, 6, 9 and 12 months. RESULTS: 28 children (experimental group: n=15, control group: n=13) participated in the study. 11 participants (experimental: n=4, control: n=7) did not complete all five measurements, as they needed additional treatment. No significant difference was found in the decrease of ankle-foot dorsiflexion range of motion between the experimental and control groups (difference: -1.05°, 95% confidence interval: -4.71° - 2.61°). In addition, secondary outcome measures did not show differences between groups. Despite good motivation, knee-ankle- foot orthosis wearing time was limited to a mean±SD of 3.2±1.9 hours per prescribed night due to discomfort. CONCLUSIONS: Knee-ankle- foot orthosis with dynamic ankle and fixed knee are poorly tolerated and are not beneficial in preventing a reduction in ankle-foot dorsiflexion range of motion in children with spastic cerebral palsy, at least with limited use.
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Authors | Jc Maas, Aj Dallmeijer, Pa Huijing, Je Brunstrom-Hernandez, Pj van Kampen, Eam Bolster, C Dunn, K Herndon, Rt Jaspers, Jg Becher |
Journal | Clinical rehabilitation
(Clin Rehabil)
Vol. 28
Issue 10
Pg. 1025-38
(Oct 2014)
ISSN: 1477-0873 [Electronic] England |
PMID | 25082956
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | © The Author(s) 2014. |
Topics |
- Cerebral Palsy
(complications, rehabilitation)
- Child
- Equinus Deformity
(etiology, prevention & control)
- Female
- Gait Disorders, Neurologic
(etiology, rehabilitation)
- Humans
- Lower Extremity
(physiology, physiopathology)
- Male
- Multilevel Analysis
- Netherlands
- Orthotic Devices
(adverse effects, statistics & numerical data)
- Range of Motion, Articular
(physiology)
- Time Factors
- United States
(ethnology)
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