ABSTRACT
Introduction: Cerebral Palsy (CP) is characterized by a disorder of posture and movement, commonly leading to disabling orthopedic alterations, including muscle shortening, especially in the lower limbs. Stretching methods, performed gradually, are necessary to delay the impairment in function from muscle shortening. The use of serial casting aims to promote proper alignment, and an ideal and stable support base, in addition to better bone and joint health, leading to better posture, mobility, muscle function, and, subsequently, increased fitness and health.Objective: evaluate range of motion, postural control, and motor performance in children with CP, using serial casting, as well as to measure its effect on fitness through the autonomic nervous system (ANS).Methods: Sixty children and adolescents with CP, of both sexes, 3 to 12 years of age, will be divided into three groups: Groups A, B, and C, with 20 individuals each. Group A will use serial casting, Group B will use the orthosis continuously (with removal only allowed for bathing), and Group C will use the orthosis in their daily routine. Range of motion of the ankle of first and second resistance levels (R1 and R2), gross motor function measure (GMFM), and balance (measured by BERG scale) will be used in the initial and final assessments, and after 6 months and one year of follow-up. Timed-up-and-go (TUG), load distribution (baropodometry), motor performance measured through a real basketball game and the virtual MoveHero game, analysis of body angulation with "mydartfish", and cardiac autonomic modulation through heart rate variability will be assessed in three different situations: barefoot, with orthosis, and with casting.Conclusion: Serial casting demonstrates the potential to produce positive results in the treatment of individuals with CP regarding better alignment, with consequent motor and autonomic improvement.
ABSTRACT
PURPOSE: Widely used fiberglass splints are made from straight-form material. These prove difficult to mold at joints and form wrinkles, causing complications such as pain, pressure sores, and peripheral nerve palsy. We compared the usefulness of wave-form splints with straight-form splints and the level of satisfaction of these designs from care providers and wearers. METHODS: Eighty-nine (n=89) emergency physicians and orthopedic surgeons participated in this study. The subjects (acting as care providers and mock patients) used wave-form and straight-form material to construct and wear short leg splints, long arm splints, and sugar tong splints. The clinicians were surveyed on their satisfaction as providers and wearers. All questions were measured on scores from 0 and 10(10=maximum score). After splints were removed, subjects were surveyed on the extent of splint wrinkling with scores from 1 to 3(3=maximum wrinkling). RESULTS: Provider satisfaction scores for wave-form splints versus straight-form splints in short leg splint applications were 7.76+/-1.30 vs 6.74+/-1.25 (p=0.000). Provider satisfaction scores for wave-form splints versus straight-form splints in long arm splint applications were 7.73+/-1.33 and 6.73+/-1.59 (p=0.004), respectively. The subjects felt more comfortable wearing wave-form splints, compared to straight-form splints (7.79+/-1.49 vs. 6.79+/-1.58, respectively; p=0.004) and more satisfied (8.03+/-1.35 vs. 7.18+/-1.33, respectively; p=0.003). The frequencies of wrinkle occurrence in wave-form and straight-form splints were 29.7% and 42.2%, respectively (p=0.02). CONCLUSION: Wave-form splints may be more practical for molding and wearing than traditional straight-form splints.