A Descriptive Study on Assessment of Functional Status in Cerebral Palsy Patients Using Knee Ankle Foot Orthosis

Zeenat  Arshad; Muhammad Kamran  Khan

doi:10.36082/jpost.v3i1.1503

Authors

Zeenat Arshad
Muhammad Kamran Khan

DOI:

https://doi.org/10.36082/jpost.v3i1.1503

Keywords:

Keywords cerebral palsy, Knee Ankle Foot Orthosis, Ankle Foot Orthosis, 4 point pressure system ,3 point pressure system, equines foot deformity

Abstract

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

Download data is not yet available.

References

Maas, J.C., et al., Measuring wearing time of knee-ankle-foot orthoses in children with cerebral palsy: comparison of parent-report and objective measurement. Disability and rehabilitation, 2018. 40(4): p. 398-403.

Peethambaran, A., The relationship between performance, satisfaction, and well being for patients using anterior and posterior design knee-ankle-foot-orthosis. JPO: Journal of Prosthetics and Orthotics, 2000. 12(1): p. 33-45.

Tian, F., M.S. Hefzy, and M. Elahinia, State of the art review of Knee–Ankle–Foot orthoses. Annals of biomedical engineering, 2015. 43(2): p. 427-441.

Takhakh, A.M., F.M. Kadhim, and J.S. Chiad. Vibration Analysis and Measurement in Knee Ankle Foot Orthosis for Both Metal and Plastic KAFO Type. in ASME International Mechanical Engineering Congress and Exposition. 2013. American Society of Mechanical Engineers.

Condie, D.N., The modern era of orthotics. Prosthetics and orthotics international, 2008. 32(3): p. 313-323.

Rubin, G., M. Dixon, and M. Danisi, VAPC Prescription procedures for knee orthoses and knee-ankle-foot orthoses. Orthotics and Prosthetics, 1977. 31(3): p. 9-25.

Harrington, E.D., R.S. Lin, and J. Gage, Use of the anterior floor reaction orthosis in patients with cerebral palsy. Ortho Prosthet, 1984. 37: p. 34-42.3734.

Reddihough, D.S. and K.J. Collins, The epidemiology and causes of cerebral palsy. Australian Journal of physiotherapy, 2003. 49(1): p. 7-12.

Salmon, M.K., Cerebral palsy: a webliography. Journal of Consumer Health on the Internet, 2018. 22(3): p. 244-252.

Sewell, M.D., D.M. Eastwood, and N. Wimalasundera, Managing common symptoms of cerebral palsy in children. bmj, 2014. 349.

Nelson, K.B. and J.K. Grether, Causes of cerebral palsy. Current opinion in pediatrics, 1999. 11(6): p. 487-491.

Reid, S.M., J.B. Carlin, and D.S. Reddihough, Distribution of motor types in cerebral palsy: how do registry data compare? Developmental Medicine & Child Neurology, 2011. 53(3): p. 233-238.

Levitt, S. and A. Addison, Treatment of cerebral palsy and motor delay. 2010: Wiley Online Library.

Knutson, L.M. and D.E. Clark, Orthotic devices for ambulation in children with cerebral palsy and myelomeningocele. Physical therapy, 1991. 71(12): p. 947-960.

Maas, J.C., et al., Splint: the efficacy of orthotic management in rest to prevent equinus in children with cerebral palsy, a randomised controlled trial. BMC pediatrics, 2012. 12(1): p. 1-13.

Maas, J., et al., A randomized controlled trial studying efficacy and tolerance of a knee-ankle-foot orthosis used to prevent equinus in children with spastic cerebral palsy. Clinical rehabilitation, 2014. 28(10): p. 1025-1038.

Patané, F., et al., WAKE-up exoskeleton to assist children with Cerebral Palsy: design and preliminary evaluation in level walking. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 2017. 25(7): p. 906-916.

Blaya, J., D. Newman, and H. Herr, Active Ankle Foot Orthoses (AAFO). Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, 2002: p. 275-277.

Martin Bax, Murray Goldstein, Peter Rosenbaum, Alan Leviton, Nigel Paneth, Bernard Dan, B Jacobsson and Diane Damiano Proposed definition and classification of cerebral palsy, April 2005 Cambridge University Press: 14 July 2005

Sudip Paul, 1 Anjuman Nahar, 1 Mrinalini Bhagawati, 1 and Ajaya Jang Kunwar A Review on Recent Advances of Cerebral Palsy 2022 Jul 30. doi: 10.1155/2022/2622310