Multidimensional Effects of Solid and Hinged Ankle-Foot Orthosis in Children With Cerebral Palsy.

PURPOSE: To compare the effect of solid (SAFO) and hinged (HAFO) ankle-foot orthoses in children with cerebral palsy spastic diplegia and true equinus and jump gait. METHODS: Participants were 26 children (13 wore SAFO and 13 wore HAFO) aged 4 to 14 years classified as Gross Motor Function Classification System levels I to III. Children were tested on standardized measures of body structure and function, activity, and participation. RESULTS: Children wearing HAFO reached further in standing than those wearing SAFO. Among children who walked without an assistive device, children wearing HAFO had greater stride length and faster velocity. Mean Gross Motor Function Measure and Pediatric Evaluation of Disability Inventory mobility scores did not differ between groups. The cost-to-benefit ratios showed parents preferred HAFO. CONCLUSIONS: Among children with true equinus and jump gait, the effects of HAFO were greater in children who walked without an assistive mobility device.

Evaluation of the multidimensional effects of adaptive seating interventions for young children with non-ambulatory cerebral palsy.

PURPOSE: To investigate the short-term effectiveness of the first adaptive seating system received by children with non-ambulatory cerebral palsy (CP) who are classified as level IV or V according to the Gross Motor Function Classification System. MATERIALS AND METHODS: A trained clinical assessor examined 20 children with non-ambulatory CP (mean age: 4.5 years) for their trunk control ability in static, active, and reactive tasks using the Segmental Assessment of Trunk Control. Their primary caregivers were also interviewed about their child's activity and participation using the Paediatric Evaluation of Disability Inventory Computer - Adaptive Test in daily activity and social/cognitive domains and Family Impact of Assistive Technology Scale for Adaptive Seating in child and family functioning domains. Data for each measure were collected 3 times: at baseline (pre-intervention) and then 6 weeks and 3 months after children received their first adaptive seating system. RESULTS AND CONCLUSION: The static and active trunk control scores between baseline and 6 weeks, and baseline and 3 months significantly improved. Daily activity scaled scores significantly improved between baseline and 3 months, and 6 weeks and 3 months. Significant, large gains in child and family functioning overall were detected between baseline and 6 weeks, and baseline and 3 months. These findings provide emerging evidence of multidimensional effects associated with the introduction of a first adaptive seating system into the lives of young children with non-ambulatory CPIMPLICATIONS FOR REHABILITATIONThe introduction of an adaptive seating system into the wheelchair of children with non-ambulatory cerebral palsy may be associated with short-term gains in body function, activities, participation and aspects of the child's environment.