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Mirbagheri SS, Bahramizadeh M, Aminian G, Dalvand H, Farahmand F, Vahedi M. A case series on the effect of dynamic neoprene orthosis on lower limb kinematic variables in children with cerebral palsy. J Pediatr Rehabil Med 2024; 17:131-138. [PMID: 37694316 PMCID: PMC10977358 DOI: 10.3233/prm-200806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 04/27/2023] [Indexed: 09/12/2023] Open
Abstract
PURPOSE This study examined the effects of a dynamic neoprene orthosis on kinematic variables of gait in children with spastic bilateral cerebral palsy (CP). METHODS Five children (whose median age was 9.6 years and who ranged in age from six to 12) with spastic bilateral CP and flexed knee at levels I-III of the Gross Motor Function Classification System were examined using kinematic gait analysis in three different conditions: 1) with dynamic neoprene orthosis; 2) without dynamic neoprene orthosis (immediate effect); and 3) without orthosis after six weeks of intervention. RESULTS The comparison between condition one (with dynamic neoprene orthosis) and condition two (without dynamic neoprene orthosis) demonstrated the existence of improvements in minimum hip and knee flexion variables. Moreover, the results indicated that the improvements remained constant in several key gait variables after six weeks. CONCLUSION The results varied from subject to subject, and there were signs of improvement in some of the subjects. Therefore, it was not possible to draw conclusions at a group level. Nonetheless, a number of individuals may benefit from this type of orthosis.
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Affiliation(s)
- Sedigheh Sadat Mirbagheri
- Department of Orthotic and Prosthetic, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mahmood Bahramizadeh
- Department of Orthotic and Prosthetic, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Gholamreza Aminian
- Department of Orthotic and Prosthetic, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamid Dalvand
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzam Farahmand
- Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran
| | - Mohsen Vahedi
- Department of Biostatistics and Epidemiology, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Lynn J, Wolf A, Bridges T, Pottanat Z, Spivey S, Rolin O. Effects of stochastic resonance stimulation on manual function in children with hemiplegic cerebral palsy: A pilot clinical trial. PM R 2023; 15:302-313. [PMID: 35187840 DOI: 10.1002/pmrj.12788] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 12/23/2021] [Accepted: 01/14/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the effect of stochastic resonance stimulation (SRS) on manual abilities in children with hemiplegic cerebral palsy. DESIGN This pilot study is a randomized, sham-controlled, one-period, crossover trial. SETTING A neuroscience clinic with specialty therapy programs at an urban, university-based children's hospital. PARTICIPANTS Sixteen children ages 3 to 16 years who were diagnosed with hemiplegic cerebral palsy and had hand Manual Abilities Classification scale score of I to III with sufficient cognitive abilities to follow instructions. INTERVENTIONS Children donned wrist and arm bands that delivered SRS via embedded piezoelectric actuators in two randomly assigned conditions: sham (devices powered off) and subthreshold stimulation (SBT-SRS). Following the randomized protocol, a subset of participants also completed an open-label, above-threshold stimulation (AT-SRS) condition. Children carried out the same uni-manual and bimanual tasks during the randomized and open-label protocols; all data were collected in a single session. MAIN OUTCOME MEASURE(S) Box and Blocks (B&B) test, a uni-manual function test, and the Shriners Hospital Upper Extremity Evaluation (SHUEE). The SHUEE was video recorded and scored by two raters who were blinded to the experimental condition. RESULTS Thirteen children completed the B&B task and 14 children completed the SHUEE. Children in the SBT-SRS condition relative to sham condition moved an average of 1.8 more blocks in 1 minute (p = .08); scored an average of 3 points higher on SHUEE spontaneous functional analysis (p < .002); and scored an average of 2.7 points higher on SHUEE dynamic positional analysis (p = .20). In the open-label protocol, children in the AT-SRS condition relative to sham moved 3.9 more blocks than in the sham condition (n = 8, p < .001); scored an average of 4.5 points higher on SHUEE spontaneous functional analysis (n = 6, p = .08); and scored an average of 10.5 points higher on SHUEE dynamic positional analysis (n = 6, p = .01). CONCLUSION(S) In this pilot study, we found preliminary evidence that children with hemiplegic cerebral palsy demonstrated improved uni-manual abilities and increased function of the impaired hand on bimanual tasks when receiving a single session of SBT-SRS. Preliminary evidence also suggests that some children with hemiplegic cerebral palsy may improve more when receiving a single session of AT-SRS. Future research using larger, controlled studies should evaluate the optimal intensity, duration, and long-term effect of SRS for improving impaired manual abilities.
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Affiliation(s)
- Jessica Lynn
- Occupational Therapist: Children's Hospital of Richmond at VCU, Richmond, Virginia, USA
| | - Allison Wolf
- Occupational Therapist: Children's Hospital of Richmond at VCU, Richmond, Virginia, USA
| | - Travis Bridges
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Systems, Richmond, Virginia, USA
| | - Zachary Pottanat
- Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Suzanne Spivey
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Systems, Richmond, Virginia, USA
| | - Olivier Rolin
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Systems, Children's Hospital of Richmond, Richmond, Virginia, USA
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Béghin L, Mohammad Y, Fritot S, Letellier G, Masson S, Zagamé Y, Donskoff C, Toussaint-Thorin M, Gottrand L. Safety and adherence of pressure garment therapy in children with upper limb unilateral cerebral palsy. Results from a randomized clinical trial ancillary analysis. Front Pediatr 2023; 11:1043350. [PMID: 37025290 PMCID: PMC10071041 DOI: 10.3389/fped.2023.1043350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/10/2023] [Indexed: 04/08/2023] Open
Abstract
Background This study was conducted to assess the safety and adherence of the use of a PGT (Pressure Garment Therapy) Lycra® sleeve to treat upper limb unilateral cerebral palsy (UCP) in children. Methods This study was conducted as a prospective, placebo-controlled, double-blinded, randomized monocenter study. Included in the study were 58 UCP children, 49 of whom were analyzed. 25 children (mean age 6.6 ± 1.6 years; 12 girls) were allocated to the active group vs. 24 (mean age 6.7 ± 1.6 years; 10 girls) in the placebo group. The intervention consisted of an active PGT Lycra® arm sleeve manufactured to generate a homogeneous pressure ranging from 15 to 25 mmHg. The placebo PGT Lycra® sleeve was manufactured to generate a homogeneous pressure under 7 mmHg. The time of wearing period was set at 3 h/day at minimum and 6 h/day at maximum, over the course of 6 months. The main outcome measures were safety outcomes including the number and intensity of Adverse Events of Special Interest (AESIs). AESIs were defined as adverse events imputable to compressive therapy and Lycra® wearing. Level of adherence was expressed in percentage of number of days when the sleeve was worn for at least 3 h per day compared to length of duration in days (start and end date of wearing period). Results Frequency of AESIs were very low and no different between groups (4.12 ± 11.32% vs. 1.83 ± 3.38%; p = 0.504). There were no differences in adherence (91.86 ± 13.86% vs. 94.30 ± 9.95%; p = 0.425). Conclusion The use of PGT Lycra® arm sleeve in children with UCP is safe and well-tolerated with a very good adherence. The low rate of AESIs is promising for further randomized clinical trials on efficacy.
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Affiliation(s)
- Laurent Béghin
- CIC 1403 – Clinical Investigation Center. Lille University Hospital Inserm, Lille, France
- University of Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
- Correspondence: Laurent Beghin
| | - Yasser Mohammad
- Pediatric Physical Medicine and Rehabilitation Center APF, Creil, France
- Rehabilitation Center, Beaumont sur Oise, France
| | - Séverine Fritot
- Physical Medicine and Rehabilitation Department, CHU Amiens, Amiens, France
| | - Guy Letellier
- Pediatric Physical Medicine and Rehabilitation Center (ESEAN-APF), Nantes, France
| | - Sixtine Masson
- Physical Medicine and Rehabilitation Center APF (Centre Marc Sautelet), Villeneuve-d’Ascq, France
| | | | - Catherine Donskoff
- Physical Medicine and Rehabilitation Department, Paul Dottin Center, Ramonville-Saint-Agne, France
| | | | - Laurence Gottrand
- Pediatric Physical Medicine and Rehabilitation Center, CHU Reims, Reims, France
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Gerard A, Toussaint-Thorin M, Mohammad Y, Letellier G, Fritot S, Masson S, Duhamel A, Donskoff C, Zagame Y, Beghin L, Gottrand L. PROPENSIX: pressure garment therapy using compressive dynamic Lycra® sleeve to improve bi-manual performance in unilateral cerebral palsy: a multicenter randomized controlled trial protocol. Trials 2022; 23:117. [PMID: 35123557 PMCID: PMC8817585 DOI: 10.1186/s13063-022-06041-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/19/2022] [Indexed: 12/01/2022] Open
Abstract
Background Upper limb impairment affects activity and participation in children with unilateral cerebral palsy (UCP). Pressure garment therapy (PGT) using compressive dynamic Lycra® garments is an innovative intervention proposed for the management of cerebral palsy consequences. The PROPENSIX study aims to evaluate the efficacy of a therapy using a Lycra® sleeve as compared to a placebo sleeve to improve bi-manual performance measured by the Assisting Hand Assessment (AHA) in children with unilateral cerebral palsy. Methods The PROPENSIX trial is a multicenter, prospective, placebo-controlled, double-blinded, randomized study. One hundred children with UCP, aged from 5 to 10, are randomly assigned as soon as they are recruited in a 1:1 ratio to perform usual daily activities, especially activities involving bimanual performances, with Lycra® sleeve or placebo sleeve during 6 months. The primary endpoint is the change in bimanual performance from inclusion to 6 months, evaluated by AHA. The secondary endpoints evaluate changes from inclusion to 6 months in other dimensions of the International Classification of Functioning (ICF), upper limb movement capacity assessed by Quality of Upper Extremity Skill Test (QUEST), and health-related quality of life evaluated by Pediatric Quality of Life Inventory 3.0 Cerebral Palsy Module (PedsQLTM 3.0 CP Module) and in body structures and functions domain assessed by neuro-orthopedic examination and somatosensory evoked potentials (SEP). Discussion The PROPENSIX study is the largest randomized controlled trial (RCT) aiming to evaluate the efficacy of a PGT using compressive dynamic Lycra® sleeve in UCP. Enhancement of children’s bimanual performance at the end of the 6 months wear of the Lycra® sleeve should improve evidence regarding this type of treatment and expand discussion about their recommendation in clinical practice. Data from secondary outcomes assessments should bring interesting arguments to discuss the Lycra® sleeve action on mobility, tonus, and sensory impairments in children with unilateral cerebral palsy. Trial registration ClinicalTrials.govNCT02086214. Retrospectively registered on March 13, 2014 Trial status Study start data: December 2012. Recruitment status: completed. Primary completion date: April 2021. Estimated study completion date: December 2022. Protocol version 10 (date: February 2018).
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Broatch JR, Halson SL, Panchuk D, Bishop DJ, Waddington G. Compression enhances lower‐limb somatosensation in individuals with poor somatosensation, but impairs performance in individuals wth good somatosensation. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.214] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- James R. Broatch
- Institute for Health and Sport (iHeS) Victoria University Melbourne Vic. Australia
- Australia Institute of Sport Canberra ACT Australia
| | - Shona L. Halson
- Australia Institute of Sport Canberra ACT Australia
- School of Behavioural and Health Sciences Australian Catholic University Melbourne Vic. Australia
| | | | - David J. Bishop
- Institute for Health and Sport (iHeS) Victoria University Melbourne Vic. Australia
| | - Gordon Waddington
- Australia Institute of Sport Canberra ACT Australia
- University of Canberra Research Institute for Sport and Exercise Canberra ACT Australia
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Ooi HK, Chai SC, Kadar M. Effects of pressure garment on spasticity and function of the arm in the early stages after stroke: a randomized controlled trial. Clin Rehabil 2020; 34:515-523. [PMID: 32037862 DOI: 10.1177/0269215520905050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the effects of pressure (Lycra) garment on the spasticity and function of the arm in the early stages after stroke. DESIGN A randomized controlled trial. SETTING Occupational therapy unit of a public hospital. SUBJECTS A total of 46 adults with stroke. INTERVENTION After random assignment, for six weeks, both intervention group and control group received a 2 hour/week conventional occupational therapy program, with the intervention group receiving an extra 6 hour/day pressure garment application (long glove). MAIN MEASURES Modified Modified Ashworth Scale, Disabilities of Arm, Shoulder and Hand Outcome Measure, and Jebsen-Taylor Hand Function Test. Eligibility measures: Mini Mental State Examination and Modified Modified Ashworth Scale. Assessments were performed at baseline and six weeks postintervention. RESULTS There were 21 participants with the mean age of 51.19 (8.28) years in the intervention group and 22 participants with the mean (SD) age of 52.82 (8.71) years in the control group. The intervention group had median (interquartile range (IQR)) post-stroke duration of 1 (1) month, while for the control group, they were 2 (2) months. There was no difference in spasticity, and both perceived and actual arm functions between the groups at six weeks after baseline. CONCLUSION Wearing a pressure garment on the arm for 6 hours daily had no effect in controlling spasticity or on improving arm function in the early stages after stroke.
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Affiliation(s)
- Hwa Kee Ooi
- Occupational Therapy Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Occupational Therapy Unit, Hospital Tuanku Fauziah, Kangar, Perlis, Malaysia
| | - Siaw Chui Chai
- Occupational Therapy Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Masne Kadar
- Occupational Therapy Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Moraes DSD, Teixeira RDS, Santos MDS. Profile of the judicialization of the Therasuit Method and its direct cost in the scope of the state of Rio de Janeiro. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22:e190006. [PMID: 30892469 DOI: 10.1590/1980-549720190006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/23/2018] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The lack of availability of the Therasuit Method by the Unified Health System associated with its high cost has led to the prosecution of this treatment. The study aimed to outline the profile of this judicialization, as well as to estimate the direct costs resulting from compliance with the deferred judicial decisions. METHOD Weanalyzed the cases submitted to the Court of Justice of Rio de Janeiro between January 2013 and January 2017, in which the Therasuit Method was applied. Demographic, clinical, advocacy and legal data were extracted, as was the timing of the court's decision and the required technology budgets. RESULTS Atotal of 11 processes was analyzed. The authors had a mean age of 6.8 years and a median of 6, the majority being male, and resident in thestate capital. Quadriparesis was the most reported condition. The gratuity of justice was requested by all, and the Public Defender's Officewas used by 9 of the 11 processes. The judicial decisions at first instance were considered. In all of processes there was application of the legal tool called guardianship. The time of the judicial decision was on average of 266.5 days with a median of 35.5. The deferral index was 90%, totaling an annual direct cost of R$501,894.09. DISCUSSION The judicialization of this treatment can cause an unforeseen displacement of public funds, transgressing the principles of equity and the integrality of Unified Health System. CONCLUSION It was observed a high rate of deferred processes, resulting in a high cost spent by the Public Power to attend a small portion of patients.
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Karadağ-Saygı E, Giray E. The clinical aspects and effectiveness of suit therapies for cerebral palsy: A systematic review. Turk J Phys Med Rehabil 2019; 65:93-110. [PMID: 31453550 PMCID: PMC6648185 DOI: 10.5606/tftrd.2019.3431] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 12/18/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The aim of this review to evaluate the clinical aspects and effectiveness of suit therapy for patients with cerebral palsy (CP). MATERIALS AND METHODS A literature search was performed in the PubMed, SCOPUS, Web of Science, and PEDro databases within the period from the establishment of the relevant database to July 2018. The articles were categorized according to their study design. We included studies published in peer-review journals focusing on the efficacy of suit therapies for CP and excluded review articles, duplications, non-related articles. A narrative synthesis approach was used, as it was not possible to classify extracted and analyzed data, and the overall effect size was unable to be calculated. Data regarding study subjects (number, age, CP type, Gross Motor Function Classification System [GMFCS] level), suit type, intervention including dose of suit therapy, outcome measurements, outcomes, adverse effects, and funding were extracted. The method introduced by Furlan, Pennick, Bombardier, and van Tulder was used to evaluate the risk of bias for the assessment of methodological quality of randomized-controlled trials (RCTs). RESULTS A total of 29 studies were included of which 10 were Class I, eight were Class II-III, and 11 were Class IV studies. Studies were heterogenous in design, sample size, study population, and outcomes measured. The methodological quality score of RCTs varied between 4 and 10. The results of the high-quality RCTs showed that wearing the suit along with conventional therapy improved proximal stability, gross motor function, and gait. The Class II-III and IV studies supported the findings of the Class I studies. CONCLUSION The major improvements from the RCTs were seen in proximal stability, gross motor function and gait, although grading was unable to be done due to the heterogeneity of included studies. In order to obtain gains in the function, it is important to carefully consider intended use, patient selection criteria, and suit type.
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Affiliation(s)
- Evrim Karadağ-Saygı
- Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, İstanbul, Turkey
| | - Esra Giray
- Department of Physical Medicine and Rehabilitation, Marmara University School of Medicine, İstanbul, Turkey
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Martins E, Cordovil R, Oliveira R, Pinho J, Diniz A, Vaz JR. The Immediate Effects of a Dynamic Orthosis on Gait Patterns in Children With Unilateral Spastic Cerebral Palsy: A Kinematic Analysis. Front Pediatr 2019; 7:42. [PMID: 30847335 PMCID: PMC6393373 DOI: 10.3389/fped.2019.00042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 02/01/2019] [Indexed: 11/13/2022] Open
Abstract
This study analyzes the immediate effects of wearing a Therasuit on sagittal plane lower limb angular displacements during gait in children with unilateral spastic cerebral palsy (US-CP). Seven participants (median age = 7.00 years; ranging from 5.83 to 9.00 years) with US-CP, levels I and II of the Gross Motor Function Classification System, were assessed with kinematic gait analysis in three different conditions: (A) Baseline; (B) Therasuit without elastics and (C) Therasuit with elastics. Significant improvements were observed at the hip joint of both lower limbs during most of the gait cycle in participants wearing a Therasuit, including a decrease in the flexion pattern at the initial contact and swing phase in both lower limbs, and an increase in the extension pattern in the paretic lower limb during the stance phase. At the knee joint in the paretic lower limb, significant differences were found between the baseline and Therasuit with elastics conditions on the knee angle at initial contact, and between baseline and both Therasuit conditions on the flexion angle at swing phase. However, the inter-individual variability in kinematic patterns at the knee joint was high. At the ankle joint, decreased plantar flexion at initial contact and increased dorsiflexion during stance and swing phases were observed at the Therasuit with elastics condition, helping to correct the equinus-foot in the paretic lower limb during the whole gait cycle. The Z-values showed large effect sizes particularly for most of the angular hip variables in both lower limbs and for the angular ankle variables in the paretic lower limb. The Therasuit seems to have some positive immediate effects on gait kinematics in children with spastic unilateral cerebral palsy by providing a more functional and safer gait pattern. Future investigations with larger samples are recommended to further support these findings.
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Affiliation(s)
- Elisabete Martins
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal.,Escola Superior de Saúde do Alcoitão, Lisbon, Portugal
| | - Rita Cordovil
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal.,Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, Lisbon, Portugal
| | - Raul Oliveira
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Joana Pinho
- Escola Superior de Saúde do Alcoitão, Lisbon, Portugal
| | - Ana Diniz
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal.,Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, Lisbon, Portugal
| | - Joao R Vaz
- Universidade Europeia, Lisbon, Portugal.,Department of Biomechanics, University of Nebraska, Omaha, NE, United States
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Finlayson J, Crockett J, Shanmugam S, Stansfield B. Lycra splinting garments for adults with intellectual disabilities who fall due to gait or balance issues: a feasibility study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:391-406. [PMID: 29441642 DOI: 10.1111/jir.12477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 12/15/2017] [Accepted: 01/08/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Adults with intellectual disabilities (IDs) experience high rates of falls and have high rates of gait or balance issues which contribute to falls. Lycra splinting garments (LSGs) have potential to improve gait or balance, but they have never before been tested with adults with IDs who fall due to gait or balance issues. The aim of this study was to test in adults with IDs, the feasibility of using LSGs to improve movement and function and reduce falls, whilst also exploring usability and likely compliance. METHOD A convenience sample of nine adults with IDs wore tailored LSGs over a 6-week assessment period. Laboratory-based foot clearance, balance, and gait measures were collected pre- and post-LSG-wear. Falls charts and questionnaires on usability and likely compliance were also completed. RESULTS Seven participants experienced a reduction in falls during their six weeks of LSG wear; most notably in the group of five participants who wore lycra splinting socks, compared with only two in the group of four who wore lycra splinting shorts or leggings only. CONCLUSION Lycra splinting socks are likely to bring about positive outcomes for adults with IDs who fall due to gait/balance issues on an individual case by case basis over time, but further research is required to test this hypothesis under randomised controlled trial conditions. Potential benefits of more intrusive LSGs are outweighed by reported problems with usability and compliance.
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Affiliation(s)
- J Finlayson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - J Crockett
- Head of Service for Physiotherapy, Glasgow Learning Disability Services, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - S Shanmugam
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - B Stansfield
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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Does stabilizing input pressure orthosis vest, lycra-based compression orthosis, improve trunk posture and prevent hip lateralization in children with cerebral palsy? Turk J Phys Med Rehabil 2017; 64:100-107. [PMID: 31453498 DOI: 10.5606/tftrd.2018.1332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/21/2017] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to investigate whether the use of a lycra-based compression orthosis known as stabilizing input pressure orthosis (SPIO) vest improves trunk posture and hip lateralization in children with cerebral palsy (CP) and to compare the effects of two- and six-hours daily wear of the orthosis. Patients and methods Between December 2013 and July 2015, a total of 24 children with CP (5 boys, 19 girls; mean age 61.1 months; range 35 to 105 months) with impaired trunk control were included in this single-blind, randomized-controlled study. All were randomized to either of the three groups as the control group (received only conventional exercise therapy), the SPIO 2-hour group (worn orthosis two hours during therapy), and the SPIO 6-hour group (worn orthosis four hours in addition to two hours of wear during therapy). The Sitting Assessment Scale (SAS), Cobb angle, kyphotic angle, and Migration Index were used to evaluate the trunk posture and hip lateralization before treatment and at six months after treatment. Results The SAS scores improved compared to baseline in all groups. The Cobb angle and kyphotic angle showed a significant decrease at six months after treatment only in the SPIO groups, while intra-group analysis of the Migration Index did not show a statistically significant difference. Changes in the radiographic assessments were similar among the groups, except for the kyphotic angles. The kyphotic angle showed less change in the control group. Comparison of the SPIO groups showed no significant differences in terms of the variables assessed. Conclusion The SPIO vest improves the kyphotic posture, but not scoliosis and hip lateralization in children with CP with impaired trunk control when used in combination with the conventional therapy. Using the SPIO vest for two and six hours also yields similar outcomes.
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Almeida KM, Fonseca ST, Figueiredo PRP, Aquino AA, Mancini MC. Effects of interventions with therapeutic suits (clothing) on impairments and functional limitations of children with cerebral palsy: a systematic review. Braz J Phys Ther 2017; 21:307-320. [PMID: 28712784 PMCID: PMC5628369 DOI: 10.1016/j.bjpt.2017.06.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 09/25/2016] [Accepted: 09/26/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Therapeutic suits or clothing whether associated with intensive protocols or not, became popular in the rehabilitation of children with cerebral palsy. Studies have reported positive effects of these suits on children's posture, balance, motor function and gait. A summary of current literature may help guide therapeutic actions. OBJECTIVE To evaluate the available evidence on the effects of interventions based on the use of therapeutic suits in the treatment of impairments and functional limitations of children with cerebral palsy. METHOD Three independent reviewers searched for experimental studies on MEDLINE, SciELO, BIREME, LILACS, PEDro and CENTRAL databases, between October and December 2015 and updated in May 2016. The reviewers evaluated the methodological quality of selected studies using the Checklist for Measuring Quality. The Grading of Recommendations Assessment, Development and Evaluation was used to synthesize the quality of evidence and strength of recommendation. RESULTS From the 13 studies, two evaluated the Full Body Suit, two tested the Dynamic Elastomeric Fabric Orthose, three evaluated TheraTogs and six tested the TheraSuit/AdeliSuit protocols. The quality of evidence for the Full Body Suit, the Dynamic Elastomeric Fabric Orthose and the TheraSuit/AdeliSuit protocols was very low for body structure and function outcomes, while the evidence for TheraTogs was low quality. Regarding the activity outcomes, the Full Body Suit and TheraSuit showed very low quality evidence while the evidence for TheraSuit/AdeliSuit protocols were of low quality. CONCLUSION Enthusiasm with new therapeutic approaches that argue modifications in the neuromusculoskeletal impairments and functional limitations of children with cerebral palsy need to be guided by scientific evaluation. The low quality of evidence suggests caution in recommending the use of these therapeutic suits. New studies could change the findings of this review.
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Affiliation(s)
- Kênnea M Almeida
- Departamento de Educação Integrada em Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Sérgio T Fonseca
- Programa de Pós-Graduação em Ciências da Reabilitação, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Amanda A Aquino
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Marisa C Mancini
- Programa de Pós-Graduação em Ciências da Reabilitação, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
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13
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The Use of Lycra Garments in Children with Cerebral Palsy: A Report of a Descriptive Clinical Trial. Br J Occup Ther 2016. [DOI: 10.1177/030802260306600205] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to evaluate the effects of wearing Lycra garments in children with cerebral palsy. Eight participants, aged 3 years 5 months to 13 years (male = 4, female = 4) and with a diagnosis of cerebral palsy, were recruited. A repeated measures design was used, with participants tested with the Gross Motor Function Measure (GMFM) and the Quality of Upper Extremity Skills Test (QUEST) before and after intervention. Both parents and participants recorded the perceived advantages and disadvantages of the participant wearing the Lycra garment at the end of the trial. Each participant received a baseline test, was then provided with a Lycra garment and was re-tested once wear time was more than 4 hours per day. Four participants withdrew from the trial (discomfort from suit, n = 3; prescribed spinal jacket, n = 1). Of the remaining four participants, all showed an improvement in either GMFM or QUEST score and one showed improvement in both test scores. All but one of the eight participants recorded functional improvements when wearing their suit. In this population, the participants showed improvements in function when wearing a Lycra garment, but problems with discomfort remained a barrier for some children to their more sustained use.
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14
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Loturco I, Winckler C, Lourenço TF, Veríssimo A, Kobal R, Kitamura K, Pereira LA, Nakamura FY. Effects of compression clothing on speed-power performance of elite Paralympic sprinters: a pilot study. SPRINGERPLUS 2016; 5:1047. [PMID: 27462495 PMCID: PMC4940310 DOI: 10.1186/s40064-016-2681-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 06/27/2016] [Indexed: 12/03/2022]
Abstract
Background Compression garments are thought to aid performance in some selected speed–power activities owing to improved sensory feedback and proprioception. The aim of this study was to test the effects of using compression garments on speed and power-related performances in elite sprinters with visual impairment, who rely more on proprioception to perform than their Olympic peers. Eight top-level Paralympic sprinters competing in 100- and 200-m races performed, in the following order: unloaded squat jump (SJ), loaded jump squat (JS) and sprint tests over 20- and 70-m distances; using or not the compression garment. The maximum mean propulsive power value obtained during the JS attempts (starting at 40 % of their body mass, after which a load of 10 % of body mass was progressively added) was considered for data analysis purposes. The athletes executed the SJ and JS attempts without any help from their guides. Magnitude-based inference was used to analyze the results. Findings The unloaded SJ was possibly higher in the compression than the placebo condition (41.19 ± 5.09 vs. 39.49 ± 5.75 cm). Performance differences in the loaded JS and sprint tests were all rated as unclear. Conclusions It was concluded that the acute enhancement in vertical jump ability should be explored in the preparation of Paralympic sprinters during power-related training sessions. However, chronic effects in Paralympic athletes wearing compression garments need to be further tested, in order to support its use as a specific training aid.
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Affiliation(s)
- Irineu Loturco
- NAR - Nucleus of High Performance in Sport, Av. Padre José Maria, 555 - Santo Amaro, São Paulo, SP 04753-060 Brazil
| | - Ciro Winckler
- CPB - Brazilian Paralympic Committee, Brasília, DF Brazil
| | | | | | - Ronaldo Kobal
- NAR - Nucleus of High Performance in Sport, Av. Padre José Maria, 555 - Santo Amaro, São Paulo, SP 04753-060 Brazil
| | - Katia Kitamura
- NAR - Nucleus of High Performance in Sport, Av. Padre José Maria, 555 - Santo Amaro, São Paulo, SP 04753-060 Brazil
| | - Lucas A Pereira
- NAR - Nucleus of High Performance in Sport, Av. Padre José Maria, 555 - Santo Amaro, São Paulo, SP 04753-060 Brazil
| | - Fábio Y Nakamura
- NAR - Nucleus of High Performance in Sport, Av. Padre José Maria, 555 - Santo Amaro, São Paulo, SP 04753-060 Brazil ; UEL - State University of Londrina, Londrina, PR Brazil
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15
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Degelaen M, De Borre L, Buyl R, Kerckhofs E, De Meirleir L, Dan B. Effect of supporting 3D-garment on gait postural stability in children with bilateral spastic cerebral palsy. NeuroRehabilitation 2016; 39:175-81. [PMID: 27341370 DOI: 10.3233/nre-161349] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Children with cerebral palsy show dysfunctional postural control which interferes with their functional performance and daily-life activities. OBJECTIVE The aim of the study was to identify the effect of a 3D supporting garment on trunk postural control and interjoint coordination during gait in children with bilateral cerebral palsy. METHODS We analyzed tridimensional trunk motion, trunk-thigh and interjoint coordination in 15 4-10 year-old children with bilateral spastic cerebral palsy (GMFCS I or II) and 16 4-10 year-old typically developing children while walking with or without a supporting garment. RESULTS We found significantly changes in the coordination between trunk and lower limbs in children with cerebral palsy. Step velocity and cadence both increased significantly in children with cerebral palsy but in controls, the cadence remained unaltered. Interjoint coordination between hip-knee and knee-ankle was altered during the stance phase only in the subgroup of children with cerebral palsy without any limitations in ankle joint passive range of motion. CONCLUSION 3D supporting garments improve trunk-thigh and lower limb interjoint coordination in walking in children with bilateral cerebral palsy.
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Affiliation(s)
- Marc Degelaen
- Centre d'Analyse du Mouvement, Hôpital Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Rehabilitation Hospital Inkendaal, Vlezenbeek, Belgium.,Vrije Universiteit Brussel, Rehabilitation Research (RERE), Brussels, Belgium
| | - Ludo De Borre
- Centre d'Analyse du Mouvement, Hôpital Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Ronald Buyl
- Dienst Biostatistiek en Informatica, Faculteit Geneeskunde en Farmacie, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Eric Kerckhofs
- Vrije Universiteit Brussel, Rehabilitation Research (RERE), Brussels, Belgium
| | - Linda De Meirleir
- Universitair Ziekenhuis Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Bernard Dan
- Rehabilitation Hospital Inkendaal, Vlezenbeek, Belgium.,Laboratory of Neurophysiology and Movement Biomechanics Faculty of Movement Science, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
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16
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MacKenzie C, McIlwain S. Evidence-Based Management of Postural Control in a Child with Cerebral Palsy. Physiother Can 2016; 67:245-7. [PMID: 26839451 DOI: 10.3138/ptc.2014-34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The authors review and discuss the evidence exploring the use of dynamic compression garments with children with cerebral palsy. The evidence is presented in case-study format with a focus on postural control and impact on involuntary movements.
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Affiliation(s)
- Claire MacKenzie
- Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto
| | - Susan McIlwain
- Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto
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17
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Riquelme I, Zamorano A, Montoya P. Reduction of pain sensitivity after somatosensory therapy in adults with cerebral palsy. Front Hum Neurosci 2013; 7:276. [PMID: 23805086 PMCID: PMC3690353 DOI: 10.3389/fnhum.2013.00276] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 05/27/2013] [Indexed: 11/13/2022] Open
Abstract
Objective: Pain and deficits in somatosensory processing seem to play a relevant role in cerebral palsy (CP). Rehabilitation techniques based on neuroplasticity mechanisms may induce powerful changes in the organization of the primary somatosensory cortex and have been proved to reduce levels of pain and discomfort in neurological pathologies. However, little is known about the efficacy of such interventions for pain sensitivity in CP individuals. Methods: Adults with CP participated in the study and were randomly assigned to the intervention (n = 17) or the control group (n = 20). The intervention group received a somatosensory therapy including four types of exercises (touch, proprioception, vibration, and stereognosis). All participants were asked to continue their standardized motor therapy during the study period. Several somatosensory (pain and touch thresholds, stereognosis, proprioception, texture recognition) and motor parameters (fine motor skills) were assessed before, immediately after and 3 months after the therapy (follow-up). Results: Participants of the intervention group showed a significant reduction on pain sensitivity after treatment and at follow-up after 3 months, whereas participants in the control group displayed increasing pain sensitivity over time. No improvements were found on touch sensitivity, proprioception, texture recognition, or fine motor skills. Conclusion: Data suggest the possibility that somatosensory therapy was effective in eliciting changes in central somatosensory processing. This hypothesis may have implications for future neuromodulatory treatment of pain complaints in children and adults with CP.
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Affiliation(s)
- Inmaculada Riquelme
- Research Institute on Health Sciences, University of the Balearic Islands, Palma de Mallorca , Spain ; Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca , Spain
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18
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de Glanville KM, Hamlin MJ. Positive Effect of Lower Body Compression Garments on Subsequent 40-kM Cycling Time Trial Performance. J Strength Cond Res 2012; 26:480-6. [DOI: 10.1519/jsc.0b013e318225ff61] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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19
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Neurorehabilitation im Kindesund Jugendalter. NeuroRehabilitation 2010. [DOI: 10.1007/978-3-642-12915-5_35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Pearce AJ, Kidgell DJ, Grikepelis LA, Carlson JS. Wearing a sports compression garment on the performance of visuomotor tracking following eccentric exercise: A pilot study. J Sci Med Sport 2009; 12:500-2. [DOI: 10.1016/j.jsams.2008.06.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Revised: 05/27/2008] [Accepted: 06/02/2008] [Indexed: 10/21/2022]
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21
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Abstract
PURPOSE Therapeutic taping to address dysfunctional sitting control in children with cerebral palsy (CP) was investigated in this study. METHODS Eighteen children with quadriplegic CP, Gross Motor Function Classification System for Cerebral Palsy levels IV (n = 9) and V (n = 9) participated in the 12-week program. Subjects were assigned randomly to one of two groups: therapeutic taping + physical therapy or physical therapy only. Therapeutic taping was applied for periods of up to 72 hours over the paraspinal region. The effects were assessed with the Gross Motor Function Measure (GMFM-88) at baseline, six weeks, and 12 weeks. A factorial analysis of variance was used to examine group differences over time. RESULTS No significant differences were found for the GMFM-88 scores between groups over time. CONCLUSION Therapeutic taping does not evoke a positive functional change in the seated postural control of children with quadriplegic cerebral palsy. Subjective observation, however, suggested that one child with athetosis benefited from therapeutic taping over the paraspinal region.
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Attard J, Rithalia S. A review of the use of Lycra pressure orthoses for children with cerebral palsy. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2004. [DOI: 10.12968/ijtr.2004.11.3.13384] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jes Attard
- Institute for Health and Social Care Research, School of Healthcare Professions, University of Salford, Manchester M5 4WT, UK
| | - Shyam Rithalia
- Institute for Health and Social Care Research, School of Healthcare Professions, University of Salford, Manchester M5 4WT, UK
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23
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Rennie DJ, Attfield SF, Morton RE, Polak FJ, Nicholson J. An evaluation of lycra garments in the lower limb using 3-D gait analysis and functional assessment (PEDI). Gait Posture 2000; 12:1-6. [PMID: 10996291 DOI: 10.1016/s0966-6362(00)00066-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Whole body lycra garments were assessed in eight children using gait analysis, the paediatric evaluation of disability index (PEDI), and a questionnaire of parental acceptance. Seven of the children had cerebral palsy and one Duchennes muscular dystrophy. After initial assessment and fitting of the garment, there was a 2-week introduction period followed by 6 weeks of wearing the garment for at least 6 h everyday, following which they were re-assessed. The root mean square error (RMSE) was used as a measure of variability over three separate passes through the gait laboratory and was a reference figure for gait stability. Proximal stability around the pelvis improved for five children and distal stability improved for three. Five children improved in at least one aspect of the PEDI scale. Although the parents and children detected these improvements, they did not outweigh the disadvantages of wearing the suit and as a consequence only one out of eight families considered continuing with the lycra garment.
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Affiliation(s)
- D J Rennie
- Gait Analysis Laboratory (DRI), Southern Derbyshire Acute Hospitals, NHS Trust, London Rd., DE1 2QY, Derby, UK
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