A Descriptive Study on Assessment of Functional Status in Cerebral Palsy Patients Using Knee Ankle Foot Orthosis
Keywords:
Keywords cerebral palsy, Knee Ankle Foot Orthosis, Ankle Foot Orthosis, 4 point pressure system ,3 point pressure system, equines foot deformity, Cerebral palsy, Knee Ankle Foot Orthosis, Ankle Foot Orthosis, Point Pressure System, Equinus Foot DeformityAbstract
Background: Cerebral Palsy (CP) is the most prevalent motor disability in childhood, arising from abnormal brain development or damage, affecting muscle control. Knee Ankle Foot Orthoses (KAFO) is a lower limb orthosis extending from foot plate to thigh level, designed to support weakened leg muscles and stabilize knee and ankle joints, potentially halting deformity progression or rectifying flexibility. This study aims to elucidate the functional status of lower limb CP patients utilizing KAFO. Aims: This study aimed to describe the functional level of lower limb CP patients wearing KAFO. Methods: Informed consent was obtained, and data of 110 cerebral palsy patients were collected using non-random consecutive sampling. Patients were divided into two groups: one with 80 patients utilizing KAFO with 4PPS (four-point pressure system), and the other with 30 patients not using KAFO with 4PPS. Observational gait analysis was conducted, and subjective and objective details were recorded on a specially designed questionnaire. The OPUS scale evaluated the functional status of CP patients, and statistical analysis employed chi-square tests to examine the role of KAFO in their functional status using SPSS version 21.0. Results: Statistical analysis revealed a significant relationship between total functional score and KAFO use. Among the 80 KAFO users, 71 patients scored >40, while 9 scored <40. In the non-KAFO group, 28 patients scored <40, and 2 scored >40. KAFO users exhibited higher total functional scores, indicating improved functionality and independence in daily activities (p<0.05). Conclusion: The study concludes that KAFO utilization enhances the functional status of cerebral palsy patients, facilitating independent engagement in daily activities. Comparison of total scores between KAFO users and non-users underscores the association between functional improvement and KAFO use.Downloads
References
Andrysek, J., Klejman, S., & Kooy, J. (2013). Examination of Knee Joint Moments on the Function of Knee-Ankle-Foot Orthoses during Walking. Journal of Applied Biomechanics, 29(4), 474–480. https://doi.org/10.1123/jab.29.4.474
Andrysek, J., Leineweber, M. J., & Lee, H. (2017). Development and evaluation of a mechanical stance-controlled orthotic knee joint with stance flexion. Journal of Mechanical Design, 139(3). https://doi.org/10.1115/1.4035372/384145
Bhave, A., Sodhi, N., Anis, H. K., Ehiorobo, J. O., & Mont, M. A. (2019). Static progressive stretch orthosis-consensus modality to treat knee stiffness-rationale and literature review. Ann Transl Med, 7(7). https://doi.org/10.21037/atm.2019.06.55
Caliskan Uckun, A., Celik, C., Ucan, H., & Ordu Gokkaya, N. K. (2014). Comparison of effects of lower extremity orthoses on energy expenditure in patients with cerebral palsy. Neurorehabilitation, Developmental 17(6), 388–392. https://doi.org/10.3109/17518423.2013.830653
Chan, G., & Miller, F. (2014). Assessment and treatment of children with cerebral palsy. The Orthopedic Clinics of North America, 45(3), 313–325. https://doi.org/10.1016/J.OCL.2014.03.003
Dessery, Y., Belzile, É. L., Turmel, S., & Corbeil, P. (2014). Comparison of three knee braces in the treatment of medial knee osteoarthritis. The Knee, 21(6), 11071114. https://doi.org/10.1016/J.KNEE.2014.07.024
Dvorznak, M., Fitzpatrick, K., Karmarkar, A., Kelleher, A., & McCann, T. (2006). Orthotic devices. In An Introduction to Rehabilitation Engineering (pp. 287-312). CRC Press.
Kempfer, J., Lewis, R., Fiedler, G., & Silver-Thorn, B. (2022). Prosthetic and orthotic devices. Rehabilitation Engineering: Principles and Practice, 525-560.
Maas, J. C., Dallmeijer, A. J., Huijing, P. A., Brunstrom-Hernandez, J. E., Van Kampen, P. J., Bolster, E. A. M., Dunn, C., Herndon, K., Jaspers, R. T., & Becher, J. G. (2014). A randomized controlled trial studying efficacy and tolerance of a knee-ankle-foot orthosis used to prevent equinus in children with spastic cerebral palsy. https://doi.org/10.1177/0269215514542355.
Mahmoudi, M., Kaviyani, M., & Poorghasem, A. (2019). Evaluation of the Effect of the New Three Point Pressure Knee Orthosis on the Kinetic and Kinematic Parameters of the Patients With Mild to Moderate Knee Osteoarthritis. Journal of Rehabilitation, 314–325. https://doi.org/10.32598/RJ.19.4.314
Nouri, A., Wang, L., Li, Y., & Wen, C. (2023). Materials and Manufacturing for Ankle–Foot Orthoses: A Review. Advanced Engineering Materials, 25(20), 2300238. https://doi.org/10.1002/ADEM.202300238
Ramachandran, M., James, K., & Mitchell, L. (2018). Orthotics. Sciences, Basic Orthopaedic 403–414. https://doi.org/10.1201/978131511729428
Shivers, E., & Day, S. (2024). A Literature Review of the Causes of Congenital Limb Deficiencies over the Last 20 Years. Journal of Prosthetics and Orthotics, 36(1), E8–E17. https://doi.org/10.1097/JPO.0000000000000444
Wright, E., & DiBello, S. A. (2020). Principles of Ankle-Foot Orthosis Prescription in Ambulatory Bilateral Cerebral Palsy. Physical Medicine and Rehabilitation Clinics of North America, 31(1), 69–89. https://doi.org/10.1016/J.PMR.2019.09.007
Yan, T., Cempini, M., Oddo, C. M., & Vitiello, N. (2015). Review of assistive strategies in powered lower-limb orthoses and exoskeletons. Robotics and Autonomous Systems, 64, 120–136. https://doi.org/10.1016/J.ROBOT.2014.09.032
Published
How to Cite
Issue
Section
Copyright (c) 2024 Journal of Prosthetics Orthotics and Science Technology (JPOST)

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.