Effect of Hinged Ankle-Foot Orthoses on Standing Balance Control in Children with Bilateral Spastic Cerebral Palsy
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초록
Purpose: To identify the characteristics of static standing balance and its postural control mechanisms during quiet side-by-side standing and the changes in these measures whilst wearing hinged ankle-foot orthoses (AFOs) in children with bilateral spastic cerebral palsy (CP). Materials and Methods: Twenty-one children with bilateral spastic CP (6.10 ± 1.09 year-old) and 22 typically developing (TD)children (5.64 ± 0.49 year-old) were recruited. Pressure data were recorded while subjects with or without AFOs stood on dual force platforms and net body center of pressure (CoP) coordinates were calculated from this data. Net body CoP was traced for measuring mediolateral (ML) and anteroposterior (AP) displacement and path length per second. Correlation coefficients between parameters representing ankle,hip, and transverse body rotation strategies were also analyzed. Results: ML and AP displacement and path length per second of the CoP trajectory were higher in children with CP compared to TD children (p < 0.05). There were no significant improvements in these parameters whilst wearing hinged AFOs. Compared to TD children, children with CP used less ankle strategy though more hip and transverse rotation strategies for postural control during quiet standing. Whilst wearing hinged AFOs, the contribution of ankle strategy was significantly increased for ML balance control in children with CP (p < 0.05). Conclusion: Hinged AFOs for children with CP may be helpful in improving the postural control mechanisms but not the postural stability in quiet side-by-side standing.
Abstract
Purpose: To identify the characteristics of static standing balance and its postural control mechanisms during quiet side-by-side standing and the changes in these measures whilst wearing hinged ankle-foot orthoses (AFOs) in children with bilateral spastic cerebral palsy (CP). Materials and Methods: Twenty-one children with bilateral spastic CP (6.10 ± 1.09 year-old) and 22 typically developing (TD)children (5.64 ± 0.49 year-old) were recruited. Pressure data were recorded while subjects with or without AFOs stood on dual force platforms and net body center of pressure (CoP) coordinates were calculated from this data. Net body CoP was traced for measuring mediolateral (ML) and anteroposterior (AP) displacement and path length per second. Correlation coefficients between parameters representing ankle,hip, and transverse body rotation strategies were also analyzed. Results: ML and AP displacement and path length per second of the CoP trajectory were higher in children with CP compared to TD children (p < 0.05). There were no significant improvements in these parameters whilst wearing hinged AFOs. Compared to TD children, children with CP used less ankle strategy though more hip and transverse rotation strategies for postural control during quiet standing. Whilst wearing hinged AFOs, the contribution of ankle strategy was significantly increased for ML balance control in children with CP (p < 0.05). Conclusion: Hinged AFOs for children with CP may be helpful in improving the postural control mechanisms but not the postural stability in quiet side-by-side standing.
참고문헌 (24)
- Ferdjallah M, "Analysis of postural control synergies during quiet standing in healthy children and children with cerebral palsy", Clin Biomech, 17, pp.203~210 (2002)
- Rose J, "Postural balance in children with cerebral palsy", Dev Med Child Neurol, 44, pp.58~63 (2002)
- Murray MP, "Normal postural stability and steadiness: quantitative assessment", J Bone Joint Surg Am, 57, pp.510~516 (1975)
- Winter DA, "Assessment of balance control in humans", Med Prog Technol, 16, pp.31~51 (1990)
- Riach CL, "Maturation of postural sway in young children", Dev Med Child Neurol, 29, pp.650~658 (1987)
- Wolff DR, "Postural balance measurements for children and adolescents", J Orthop Res, 16, pp.271~275 (1998)
- Winter DA, "Motor mechanisms of balance during quiet standing", J Electromyogr Kinesiol, 13, pp.49~56 (2003)
- Winter DA, "Unified theory regarding A", P and M, J Neurophysiol, pp.1996, 75[DOI]
- Winter DA, "Medial-lateral and anterior-posterior motor responses associated with centre of pressure changes in quiet standing", Neurosci Res Commun, 12, pp.141~148 (1993)
- Westberry DE, "Impact of ankle-foot orthoses on static foot alignment in children with cerebral palsy", J Bone Joint Surg Am, 89, pp.806~813 (2007)
- Balaban B, "The effect of hinged ankle-foot orthosis on gait and energy expenditure in spastic hemiplegic cerebral palsy", Disabil Rehabil, 29, pp.139~144 (2007)
- Park ES, "The effect of hinged ankle-foot orthoses on sit-to-stand transfer in children with spastic cerebral palsy", Arch Phys Med Rehabil, 85, pp.2053~2057 (2004)
- Radtka SA, "The kinematic and kinetic effects of solid, hinged, and no ankle-foot orthoses on stair locomotion in healthy adults", Gait Posture, 24, pp.211~218 (2006)
- Radtka SA, "A comparison of gait with solid and hinged ankle-foot orthoses in children with spastic diplegic cerebral palsy", Gait Posture, 21, pp.303~310 (2005)
- Rethlefsen S, "The effects of fixed and articulated ankle-foot orthoses on gait patterns in subjects with cerebral palsy", J Pediatr Orthop, 19, pp.470~474 (1999)
- Burtner PA, "Stance balance control with orthoses in a group of children with spastic cerebral palsy", Dev Med Child Neurol, 41, pp.748~757 (1999)
- 나동욱, "Is Electrical Stimulation Beneficial for Improving the Paralytic Effect of Botulinum Toxin Type A in Children with Spastic Diplegic Cerebral Palsy?", Yonsei Medical Journal, 49(4), pp.545~552 (2008), 연세대학교의과대학
- Winter DA, "An integrated EMG", biomechanical model of upper body balance and posture during human gait, 1993, pp.97, 359~367
- Rival C, "Developmental changes of static standing balance in children", Neurosci Lett, 376, pp.133~136 (2005)
- Cherng RJ, "Performance of static standing balance in children with spastic diplegic cerebral palsy under altered sensory environments", Am J Phys Med Rehabil, 78, pp.336~343 (1999)
- Burtner PA, "Stance balance control with orthoses in a group of children with spastic cerebral palsy", Dev Med Child Neurol, 41, pp.748~757 (1999)
- Pohl M, "Immediate effects of an individually designed functional ankle-foot orthosis on stance and gait in hemiparetic patients", Clin Rehabil, 20, pp.324~330 (2006)
- Chen CL, "Anterior ankle-foot orthosis effects on postural stability in hemiplegic patients", Arch Phys Med Rehabil, 80, pp.1587~1592 (1999)
- Burtner PA, "Muscle activation characteristics of stance balance control in children with spastic cerebral palsy", Gait Posture, 8, pp.163~174 (1998)