Effects of dynamic elastomeric fabric orthoses on children with cerebral palsy

Abstract

This phase 1 exploratory study aimed to establish proof of concept of the effects of dynamic elastomeric fabric orthoses (DEFOs) on the gait of children with spastic diplegic cerebral palsy. Replicated single case experiments employing an ABA methodology were carried out on eight subjects (median age 5.5 years, range 3–13 years; 4 girls/boys) utilizing quantitative/qualitative data collection. Outcome measures were: Ten metre walking test (10MWT); physiological cost index (PCI); visual analogue scale (VAS) scoring of perceived gait changes; functional mobility changes using Patient Specific Functional Scale (PSFS); subject/carer perceptions recorded in daily diaries. Results identified following analysis of quantitative data indicated a treatment effect from the orthoses which could be corroborated by participant subjective impressions and comments. Statistically significant (p < 0.05) intervention-related improvements in gait velocity and gait consistency were identified respectively in 5/8 and 4/8 subjects. Power calculations support the feasibility of a larger controlled study to further investigate this orthotic intervention. This study indicates that DEFO leggings can confer beneficial effects on the gait of some children with spastic diplegia resulting from CP. These findings have implications for orthotic intervention with this subject group.

Keywords:

• Lower limb orthotics
• evaluation studies
• physiotherapy
• gait
• diplegia
• cerebral palsy
• dynamic orthotics

Acknowledgements

Thanks are extended to the children, parents, carers and clinicians who agreed to participate in this study, D.M. Orthotics Ltd (who provided the leggings free of charge), Dr Allan Clark, (medical statistician) and Drs Penny Butler, Richard Reading and Fiona Poland for their support throughout the research.

Declaration of interest: This research work was undertaken whilst the first author (MJAM) was registered as a postgraduate research student within the originating HEI, under the academic supervision of the other authors (MJW & BR). The first author is now an employee of the company which manufactures the orthoses which were used in this study.

Notes

^*Physiological Cost index was calculated by dividing the heart rate immediately after the 10MWT exercise minus heart rate at rest by m per min.¹⁵

^†D.M. Orthotics Ltd, Tescan Units, Wilson Way, Pool Industrial Estate, Redruth, Corwall, UK.