Efficacy of Corrective Surgery for Gait and Energy Expenditure in Patients with Scoliosis: A Literature Review

The aim of this literature review was to evaluate selected original papers that measured gait parameters and energy expenditure in idiopathic scoliosis (IS) treated with surgical intervention. IS is a progressive growth disease that affects spinal anatomy, mobility, and left–right trunk symmetry. Consequently, IS can modify human gait. Spinal fusions remain the primary approach to correcting scoliosis deformities, thereby halting progression. Using the population intervention comparison outcome measure framework and selected keywords, 15 studies that met the inclusion criteria were selected. Alteration of spatial and temporal variables in patients with IS was contradictory among the selected studies. Ankle and foot kinematics did not change after surgery; however, pelvic and hip frontal motions increased and pelvic rotation decreased following surgery. Patients with IS continued to show excessive energy expenditure following surgery in the absence of a physical rehabilitation protocol. Spinal surgery may be considered for gait improvement and IS treatment. There were inadequate data regarding the effect of corrective surgery on the kinetics, energy expenditure, and muscle activity parameters.

The Effect of Soft and Rigid Cervical Collars on Head and Neck Immobilization in Healthy Subjects

STUDY DESIGN: Whiplash injury is a prevalent and often destructive injury of the cervical column, which can lead to serious neck pain. Many approaches have been suggested for the treatment of whiplash injury, including anti-inflammatory drugs, manipulation, supervised exercise, and cervical collars. Cervical collars are generally divided into two groups: soft and rigid collars. PURPOSE: The present study aimed to compare the effect of soft and rigid cervical collars on immobilizing head and neck motion. OVERVIEW OF LITERATURE: Many studies have investigated the effect of collars on neck motion. Rigid collars have been shown to provide more immobilization in the sagittal and transverse planes compared with soft collars. However, according to some studies, soft and rigid collars provide the same range of motion in the frontal plane. METHODS: Twenty-nine healthy subjects aged 18–26 participated in this study. Data were collected using a three-dimensional motion analysis system and six infrared cameras. Eight markers, weighing 4.4 g and thickened 2 cm² were used to record kinematic data. According to the normality of the data, a paired t-test was used for statistical analyses. The level of significance was set at α=0.01. RESULTS: All motion significantly decreased when subjects used soft collars (p<0.01). According to the obtained data, flexion and lateral rotation experienced the maximum (39%) and minimum (11%) immobilization in all six motions using soft collars. Rigid collars caused maximum immobilization in flexion (59%) and minimum immobilization in the lateral rotation (18%) and limited all motion much more than the soft collar. CONCLUSIONS: This study showed that different cervical collars have different effects on neck motion. Rigid and soft cervical collars used in the present study limited the neck motion in both directions. Rigid collars contributed to significantly more immobilization in all directions.

[ effect of modified floor reaction ankle foot orthosis on walking abilities in children with cerebral palsy: a case study]

Objective: This study was designed to evaluate the effectiveness of a modified Floor Reaction Ankle Foot Orthosis [FRAFO] design on gait performance in boy with cerebral palsy

Materials and Methods: In this study, one boy with diplegic cerebral palsy [CP] wore a modified FRAFO bilaterally for six weeks. Immediate effectiveness of the orthosis on improving gait and also following six weeks of gradual orthosis use were recorded. Primary outcome measures were walking speed, cadence and stride length, plus hip, knee and ankle joints range of motion that recorded by VICON motion analysis system

Results: Cadence, stride length and walking speed were all increased when the Boy with CP wore the modified FRAFO. The boy demonstrated a reduction in ankle ROM when using the modified FRAFO. The mean knee joint ROM was increased from 36.8 +/- 13.72 degrees when walking with an orthosis at baseline to 43.0 +/- 1.10 degrees when walking with an orthosis after six weeks of use. Boy with the modified FRAFO also had decreased hip flexion angle at initial contact and an extension shift during stance phase following 6 weeks of orthosis use compared to when initially donning it

Conclusion: A modified FRAFO can improve gait parameters in children with cerebral palsy

Effect of Modified Floor Reaction Ankle Foot Orthoses on Walking Abilities in Children with Cerebral Palsy

Objectives: This study was designed to evaluate the effectiveness of a modified Floor Reaction Ankle Foot Orthosis [FRAFO] design on gait performance in children with cerebral palsy.

Methods: Eight children with cerebral palsy wore a modified FRAFO bilaterally for six weeks. Motion analysis was used to assess the immediate effectiveness of the orthosis on improving gait and also following six weeks of gradual orthosis use. Primary outcome measures were walking speed, cadence and stride length, plus hip, knee and ankle joint ranges of motion. A paired T test was used to compare primary outcome measures.

Results: Cadence, stride length and walking speed were all significantly increased when the children wore the modified FRAFO [P = <0.001for speed and stride length and p=0.005 for cadence]. The children demonstrated a statistically significant reduction in ankle ROM when using the modified FRAFO. The mean knee joint ROM was increased from 36.5+/-13.32 degrees when walking with an orthosis at baseline to 43.5 +/- 1.19 degrees when walking with an orthosis after six weeks of use. Children with the modified FRAFO also had decreased hip flexion angle at initial contact and an extension shift during stance phase following 6 weeks of orthosis use compared to when initially donning it.

Discussion: Children with cerebral palsy can benefit from an improvement in gait parameters when walking with a modified FRAFO.

Prosthetic Reconstruction for a Child with a Congenital Bilateral Ear Deformity: Case Report

Objectives: Microtia is the most commonly seen congenital ear defect, and involves an auricular deformity either unilaterally or bilaterally. The aim of this study was to fabricate silicone prostheses for a child with bilateral microtia using an innovative technique.

Methods: This method involved the construction of bilateral ear prostheses using clips, which were located within the layers of the silicone superstructure.

Results: Surgical reconstruction was not indicated due to the patient's age; so prosthetic reconstruction was advised in this case.

Discussion: Two prosthetic ears were manufactured, with one being attached using an adhesive method and the other by a self suspension method. The child and his parents were very satisfied by the cosmetic and aesthetic appearance of the prostheses fitted. This technique has been proven to be suitable for pediatric patients with microtia