Article

This was a pilot and feasibility study of a crossover trial with
randomized use of ankle-foot orthoses by people with Charcot-Marie-tooth (CMT)
disease, investigating the effects of these on gait parameters, practical aspects
of use and achievement of goals. DESIGN: A randomized crossover trial. SETTING:
The community and ambulatory care. PARTICIPANTS:
Eight adults with CMT disease
type 1 or 2. INTERVENTIONS: Ligaflex, custom-made polypropylene and silicone
ankle-foot orthoses worn in randomized order for three weeks each, with a washout
week in-between; the orthoses of each participant's choice were then worn until
28 weeks. MAIN OUTCOME MEASURES: The primary outcome measure was gait velocity;
other outcome measures included Goal Attainment Scaling; Likert scores,
concerning aspects of orthosis use and gait analysis parameters. RESULTS: Gait
velocity was greatest wearing polypropylene orthoses, median 0.96 (interquartile
range (IQR) 0.75-1.18) ms(-1), compared with silicone orthoses, median 0.88
(0.71-1.12) ms(-1), and no orthosis, median 0.79 (0.56-0.84) ms(-1), P=0.006. The
silicone orthoses met goals more successfully and scored more favourably for
comfort, 5.0 (5.0-6.0), P=0.003 and pain, 5.5 (4.0-7.0), P=0.015. Future
modifications to study methodology were identified, such as a longer period of
wear and measurement of walking in different situations. CONCLUSIONS: This study
confirmed the feasibility of a larger trial. It indicated differences in walking
velocity and parameters concerning wear of the orthoses that could be explored
further. A further crossover trial would require 27 participants in order to show
a clinically meaningful difference in velocity of 0.13 ms(-1) with 90% power and alpha of 5%.

Langue : ANGLAIS