DOI QR코드

DOI QR Code

The Effects of Toe Wedges on the Spatiotemporal Gait Parameters of Adolescents with Spastic Diplegic Cerebral Palsy

발가락 벌림 교정기가 청소년기 경직형 양하지 뇌성마비의 보행에 미치는 영향

  • Jang, Jung-Jae (Department of Physical Therapy, Graduate School of Kyungnam University) ;
  • Jung, Sun-Hye (Department of Physical Therapy, Graduate School of Kyungnam University) ;
  • Kim, Myung-Jong (Department of Physical Therapy, Graduate School of Kyungnam University) ;
  • Song, Sun-Hae (Department of Physical Therapy, Graduate School of Kyungnam University) ;
  • Lee, Dong-Geon (Department of Physical Therapy, Graduate School of Kyungnam University) ;
  • Lee, Seung-Hoo (Department of Physical Therapy, Graduate School of Kyungnam University) ;
  • Jang, Na-Young (Department of Physical Therapy, Graduate School of Kyungnam University) ;
  • Choi, Ji-Won (Department of Physical Therapy, Graduate School of Kyungnam University) ;
  • Ha, Sun-Young (Department of Physical Therapy, Graduate School of Kyungnam University) ;
  • Ha, Shin-Ho (Department of Physical Therapy, Graduate School of Kyungnam University) ;
  • Hong, Soung-Kyun (Department of Physical Therapy, Graduate School of Kyungnam University) ;
  • Lee, Gyu-Chang (Department of Physical Therapy, Kyungnam University)
  • 장정재 (경남대학교 대학원 물리치료과) ;
  • 정선혜 (경남대학교 대학원 물리치료과) ;
  • 김명종 (경남대학교 대학원 물리치료과) ;
  • 송선해 (경남대학교 대학원 물리치료과) ;
  • 이동건 (경남대학교 대학원 물리치료과) ;
  • 이승후 (경남대학교 대학원 물리치료과) ;
  • 장나영 (경남대학교 대학원 물리치료과) ;
  • 최지원 (경남대학교 대학원 물리치료과) ;
  • 하선영 (경남대학교 대학원 물리치료과) ;
  • 하신호 (경남대학교 대학원 물리치료과) ;
  • 홍성균 (경남대학교 대학원 물리치료과) ;
  • 이규창 (경남대학교 물리치료학과)
  • Received : 2019.01.10
  • Accepted : 2019.03.20
  • Published : 2019.08.31

Abstract

Purpose: The purpose of the present study was to investigate the effects of toe wedges on the gait ability of adolescents with spastic diplegic cerebral palsy. Methods: Six adolescents with spastic diplegic cerebral palsy participated in this study. During the participants walked with- and without toe wedges, the gait ability was analyzed using the electronic walkway system. Gait parameters, including velocity, cadence, step length, stride length, single support time, and double support time, were collected and analyzed. Results: When the participants walked with toe wedges, there were significant improvements in gait velocity, cadence, and double support time compared to those without toe wedges (p<0.05). However, there were no significant differences in step length, stride length, and single support time. Conclusion: Toe wedges may have a positive effect on the gait ability of adolescents with spastic diplegic cerebral palsy. However, it is necessary to conduct high-quality studies to identify the effects of toe wedges.

Keywords

References

  1. Abel MF, Juhl GA, Vaughan CL, et al. Gait assessment of fixed ankle-foot orthoses in children with spastic diplegia. Archives of physical medicine and rehabilitation. 1998;79(2):126-133. https://doi.org/10.1016/S0003-9993(98)90288-X
  2. Bax M, Goldstein M, Rosenbaum P, et al. Proposed definition and classification of cerebral palsy. Developmental medicine and child neurology. 2005;47(8):571-576. https://doi.org/10.1017/S001216220500112X
  3. Chiong Y, Tay SS, Lim PA, et al. The effects of toe spreader in people with overactive toe flexors post stroke: a randomized controlled pilot study. Clinical rehabilitation. 2013;27(1):90-95. https://doi.org/10.1177/0269215512446157
  4. Chung JY, Wang GC, Bang MS, et al. Introduction to cerebral palsy. Seoul. Gunja Publishing co. 2013.
  5. Couillandre A, Maton B, Breniere Y. Voluntary toe-walking gait initiation: Electromyographical and biomechanical aspects. Experimental Brain Research. 2002;47(3):313-321. https://doi.org/10.1007/s00221-002-1254-y
  6. Danino B, Erel S, Kfir M, et al. Influence of orthosis on the foot progression angle in children with spastic cerebral palsy. Gait & posture. 2015;42(4):518-522. https://doi.org/10.1016/j.gaitpost.2015.08.006
  7. de Saca LR, Catlin PA, Segal RL. Immediate effects of the toe spreader on the tonic toe flexion reflex. Physical Therapy. 1994;74(6):561-570. https://doi.org/10.1093/ptj/74.6.561
  8. Effgen SK. Integration of the plantar grasp reflex as an indicator of ambulation potential in developmentally disabled infants. Physical Therapy. 1982;62(4):433-435. https://doi.org/10.1093/ptj/62.4.433
  9. Futagi Y, Otani K, Imai K. Asymmetry in plantar grasp response during infancy. Pediatric Neurology. 1995;12(1):54-57. https://doi.org/10.1016/0887-8994(94)00106-C
  10. Iwata M, Kondo I, Sato Y, et al. An ankle-foot orthosis with inhibitor bar: effect on hemiplegic gait. Archives of Physical Medicine and Rehabilitation. 2003;84(6):924-927. https://doi.org/10.1016/S0003-9993(03)00012-1
  11. Kapandji C. The physiology of the joints, 2nd ed. London. Churchill Livinstone. 1970.
  12. Lee KS, Ko E, Lee SY. Immediate effect of the toe spreader on tibialis anterior and peroneus longus muscle activities: a pilot study. Journal of Physical Therapy Science. 2013;25(3):293-295. https://doi.org/10.1589/jpts.25.293
  13. Nelson KB. Can we prevent cerebral palsy? The New England Journal of Medicine. 2003;349(18):1765-1769. https://doi.org/10.1056/NEJMsb035364
  14. Neto HP, Grecco LAC, Galli M, et al. Comparison of articulated and rigid ankle-foot orthoses in children with cerebral palsy: a systematic review. Pediatric Physical Therapy. 2012;24(4):308-312. https://doi.org/10.1097/PEP.0b013e318268a4fc
  15. Novak I. Evidence-based diagnosis, health care, and rehabilitation for children with cerebral palsy. Journal of Child Neurology. 2014;29(8):1141-1156. https://doi.org/10.1177/0883073814535503
  16. Oskoui M, Coutinho F, Dykeman J, et al. An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Developmental Medicine & Child Neurology. 2013;55(6):509-519. https://doi.org/10.1111/dmcn.12080
  17. Papavasiliou AS. Management of motor problems in cerebral palsy: a critical update for the clinician. European Journal of Paediatric Neurology. 2009;13(5):387-396. https://doi.org/10.1016/j.ejpn.2008.07.009
  18. Park EY. Utility of function classification system in children with cerebral palsy. Journal of the Korea AcademiaIndustrial Cooperation Society. 2011;12(12):5709-5714. https://doi.org/10.5762/KAIS.2011.12.12.5709
  19. Van U, Cornelis JT, Marcus PB. Test-retest reliability of temporal and spatial gait characteristics measured with an instrumented walkway system. BMC Musculoskeletal Disorders. 2004;5:13. https://doi.org/10.1186/1471-2474-5-13
  20. Weindling AM, Cunningham CC, Glenn SM, et al. Additional therapy for young children with spastic cerebral palsy: a randomized controlled trial. Health Technol Assess. 2007;11(16)
  21. Wesdock KA, Edge AM. Effects of wedged shoes and ankle-foot orthoses on standing balance and knee extension in children with cerebral palsy who crouch. Pediatric Physical Therapy. 2003;15(4):221-231. https://doi.org/10.1097/01.PEP.0000096383.80789.A4
  22. White H, Jenkins J, Neace WP, et al. Clinically prescribed orthoses demonstrate an increase in velocity of gait in children with cerebral palsy: a retrospective study. Developmental medicine and child neurology. 2002;44(4):227-232. https://doi.org/10.1017/S0012162201001992