Article

BACKGROUND: To date no review has been published that analyzes the efficacy of
assistive devices on the walking ability of ambulant children and adolescents
with spina bifida and, differentiates between the effects of treatment on gait
parameters, walking capacity, and walking performance. OBJECTIVES: To review the
literature for evidence of the efficacy of orthotic management, footwear, and
walking aids on gait and walking outcomes in ambulant children and adolescents
with spina bifida. STUDY DESIGN: Systematic literature review. METHODS:
A systematic literature search was performed to identify studies that evaluated the
effect of any type of lower limb orthoses, orthopedic footwear, or walking aids
in ambulant children (</=18 years old) with spina bifida. Outcome measures and
treatment results for gait parameters, walking capacity, and walking performance
were identified using International Classification of Functioning, Disability and
Health for Children and Youth (ICF-CY) as the reference framework. RESULTS: Six
case-crossover studies met the criteria and were included in this systematic
review. Four studies provided indications of the efficacy of the ankle-foot
orthosis in improving a number of kinematic and kinetic properties of gait,
stride characteristics, and the oxygen cost of walking. Two studies indicated
that walking with forearm crutches may have a favorable effect on gait. The
evidence level of these studies was low, and none of the studies assessed the
efficacy of the intervention on walking capacity and walking performance.
CONCLUSIONS: Some data support the efficacy of using ankle-foot orthosis and
crutches for gait and walking outcomes at the body functions and structures level
of the ICF-CY. Potential benefits at the activities and participation level have
not been investigated. CLINICAL RELEVANCE: This is the first evidence-based
systematic review of the efficacy of assistive devices for gait and walking
outcomes for children with spina bifida. The ICF-CY is used as a reference
framework to differentiate the effects of treatment on gait parameters, walking
capacity, and walking performance.
CI - (c) The International Society for Prosthetics and Orthotics 2014.

Langue : ANGLAIS