Article

This pilot study investigated the feasibility of reducing stance phase
knee hyperextension in children with cerebral palsy by tuning the ankle foot
orthoses-footwear combination (AFO-FC) using different sizes of wedges. METHODS:
Five children with cerebral palsy underwent three dimensional gait analysis and
tuning of their AFO-FC using wedges. Data analysis was carried out by comparing
relevant gait parameters between the non-tuned and tuned prescription. RESULTS:
Knee hyperextension during stance significantly decreased, and the shank to
vertical angle was closer to normal after tuning. Although none of the other
parameters showed statistically significant changes, the wide confidence
intervals and lack of power indicated the likelihood of a type II error. Further,
it was noted that the influence of tuning on temporal-spatial parameters was
different between children with diplegia and those with hemiplegia. It was
estimated that a sample size of 15 is required to detect significant changes at p
= 0.05 and power of 0.8. CONCLUSIONS: The findings of this study clearly indicate
the potential clinical utility of tuning using wedges to correct knee
hyperextension during the stance phase in children with cerebral palsy. However,
observations support the need for an adequately powered study to assess the long-term effects of tuning on gait parameters, activity level and quality of life.

Langue : ANGLAIS