Analysis of type and frequency dynamics of rehabilitation assistive devices in children with cerebral palsy

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Abstract

Background. Currently, cerebral palsy is the most common neuromuscular disease in the pediatric population. Spastic forms of cerebral palsy are characterized by secondary musculoskeletal complications. They are corrected by the use of assistive devices and, especially, orthoses, along with surgical treatment, botulinum toxin, and others. Aim. The aim of this study was to assess the type and frequency dynamics of rehabilitation assistive devices in children with spastic forms of cerebral palsy, depending on the level of the gross motor function of the patient. Materials and methods. A prospective analysis was conducted by questioning 214 parents of children with spastic forms of cerebral palsy who were treated for the period from 2017 to 2019. The patients were divided into five groups according to the gross motor function classification (GMFCS). The statistical processing was performed using the application package Statistica 10 and Microsoft Excel. Results. Statistically significant differences in variances (p < 0.05) were obtained between the number of rehabilitation assistive devices used in the anamnesis in the year before the questionnaire (period I) and assistive devices used in the last six months before the questionnaire (period II). Repeatedly, patients used orthopedic shoes the most often, and the trunk-hip-knee-ankle-foot orthoses the most rarely. We found five main causes groups of assistive device use failure for children with cerebral palsy. Conclusion. Statistically significant differences in variances were obtained between the frequency of rehabilitation assistive devices used in the anamnesis and during the last six months before the questionnaire was obtained. It has been confirmed that patients used orthopedic shoes most regularly; of all functional orthoses, hip adductor orthosis was used most often repeatedly, whereas the trunk-hip-knee-foot orthoses were the least common. Factors such as a negative attitude of the child towards the orthosis, uncomfortable in life, the presence of construction errors of the product, the absence of appropriate appointments in the individual rehabilitation and habilitation programs for the patient, have led to the most frequent rejection of the reuse of the technical device for rehabilitation. At the same time, positive or negative dynamics on the condition of the patient affected the regularity of the use of a technical device for rehabilitation in only one in six patients.

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About the authors

Andrey A. Koltsov

Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht

Email: katandr2007@yandex.ru
MD, PhD, Orthopedic and Trauma Surgeon, Head of the First Child’s Traumatology-Orthopedic Department 195067, Saint-Petersburg, Bestugevskaya street., 50

Elnur I. Dzhomardly

Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht

Email: mamedov.ie@yandex.ru
MD, orthopedic surgeon, PhD student 195067, Saint-Petersburg, Bestugevskaya street., 50

Vladimir Markovich Kenis

Email: kenis@mail.ru

Yuriy Alekseevich Lapkin

Email: lapkin1950@mail.ru

References

  1. Bar-On L, Aertbelien E, Molenaers G, Desloovere K. Muscle activation patterns when passively stretching spastic lower limb muscles of children with cerebral palsy. PLoS One. 2014;9(3):e91759. https://doi.org/10.1371/journal.pone.0091759.
  2. Flemban A, Elsayed W. Effect of combined rehabilitation program with botulinum toxin type A injections on gross motor function scores in children with spastic cerebral palsy. J Phys Ther Sci. 2018;30(7):902-905. https://doi.org/10.1589/jpts.30.902.
  3. Zhou JY, Lowe E, Cahill-Rowley K, et al. Influence of impaired selective motor control on gait in children with cerebral palsy. J Child Orthop. 2019;13(1):73-81. https://doi.org/10.1302/1863-2548.13.180013.
  4. Munger ME, Chen BP, MacWilliams BA, et al. Comparing the effects of two spasticity management strategies on the long-term outcomes of individuals with bilateral spastic cerebral palsy: a multicentre cohort study protocol. BMJ Open. 2019;9(6):e027486. https://doi.org/10.1136/bmjopen-2018-027486.
  5. Church C, Lennon N, Alton R, et al. Longitudinal change in foot posture in children with cerebral palsy. J Child Orthop. 2017;11(3):229-236. https://doi.org/10.1302/1863-2548.11.160197.
  6. Zhang H, Huo H, Hao Z, et al. Effect of appropriate assistive device on rehabilitation of children with cerebral palsy under ICF framework. Int J Clin Exp Med. 2018;11(11):12259-12263.
  7. Palisano R, Rosenbaum P, Walter S, et al. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997;39(4):214-223. https://doi.org/10.1111/j.1469-8749.1997.tb07414.x.
  8. Contini BG, Bergamini E, Alvini M, et al. A wearable gait analysis protocol to support the choice of the appropriate ankle-foot orthosis: A comparative assessment in children with cerebral palsy. Clin Biomech (Bristol, Avon). 2019;70:177-185. https://doi.org/10.1016/j.clinbiomech.2019.08.009.
  9. Totah D, Menon M, Jones-Hershinow C, et al. The impact of ankle-foot orthosis stiffness on gait: A systematic literature review. Gait Posture. 2019;69:101-111. https://doi.org/10.1016/j.gaitpost.2019.01.020.
  10. Ries AJ, Schwartz MH. Ground reaction and solid ankle-foot orthoses are equivalent for the correction of crouch gait in children with cerebral palsy. Dev Med Child Neurol. 2019;61(2):219-225. https://doi.org/10.1111/dmcn.13999.
  11. Белова Л.А., Бекк Н.В., Захожая Т.С., и др. Технологические решения проектирования ортопедической обуви с учетом биомеханики движений // Вестник технологического университета. – 2015. – Т. 18. – № 5. – С. 112–114. [Belova LA, Bekk NV, Zakhodzhaya TS. Tekhnologicheskie resheniya proektirovaniya ortopedicheskoy obuvi s uchetom biomekhaniki dvizheniy. Vestnik tekhnologicheskogo universiteta. 2015;18(5):112-114. (In Russ.)]
  12. Lapina T, Bekk N, Belova L. Features customization of orthopedic shoes for children with cerebral palsy. Theoretical & Applied Science. 2018;68(12):117-121. https://doi.org/10.15863/tas.2018.12.68.21.
  13. Tardieu C, Lespargot A, Tabary C, Bret MD. For how long must the soleus muscle be stretched each day to prevent contracture? Dev Med Child Neurol. 1988;30(1):3-10. https://doi.org/10.1111/j.1469-8749.1988.tb04720.x.
  14. Molenaers G, Desloovere K, De Cat J, et al. Single event multilevel botulinum toxin type A treatment and surgery: similarities and differences. Eur J Neurol. 2001;8 Suppl 5:88-97. https://doi.org/10.1046/j.1468-1331.2001.00041.x.
  15. Gage JR. The treatment of gait problems in cerebral palsy. Cambridge: Cambridge University Press; 2004. P. 423.
  16. Desloovere K, Molenaers G, De Cat J, et al. Motor function following multilevel botulinum toxin type A treatment in children with cerebral palsy. Dev Med Child Neurol. 2007;49(1):56-61. https://doi.org/10.1017/s001216220700014x.x.
  17. Семенова К.А. Лечение двигательных расстройств при детских церебральных параличах. – М.: Медицина, 1976. – 185 с. [Semenova KA. Lechenie dvigatel’nykh rasstroystv pri detskikh tserebral’nykh paralichakh. Moscow: Meditsina; 1976. 185 p. (In Russ.)]
  18. Willoughby K, Ang SG, Thomason P, Graham HK. The impact of botulinum toxin A and abduction bracing on long-term hip development in children with cerebral palsy. Dev Med Child Neurol. 2012;54(8):743-747. https://doi.org/10.1111/j.1469-8749.2012.04340.x.
  19. Shore BJ, Yu X, Desai S, et al. Adductor surgery to prevent hip displacement in children with cerebral palsy: the predictive role of the Gross Motor Function Classification System. J Bone Joint Surg Am. 2012;94(4):326-334. https://doi.org/10.2106/JBJS.J.02003.
  20. Kusumoto Y, Matsuda T, Fujii K, et al. Effects of an underwear-type hip abduction orthosis on sitting balance and sit-to-stand activities in children with spastic cerebral palsy. J Phys Ther Sci. 2018;30(10):1301-1304. https://doi.org/10.1589/jpts.30.1301.
  21. Bennett BC, Russell SD, Abel MF. The effects of ankle foot orthoses on energy recovery and work during gait in children with cerebral palsy. Clin Biomech (Bristol, Avon). 2012;27(3):287-291. https://doi.org/10.1016/ j.clinbiomech.2011.09.005.
  22. Rha DW, Kim DJ, Park ES. Effect of hinged ankle-foot orthoses on standing balance control in children with bilateral spastic cerebral palsy. Yonsei Med J. 2010;51(5):746-752. https://doi.org/10.3349/ymj.2010.51.5.746.
  23. Goodwin J, Colver A, Basu A, et al. Understanding frames: A UK survey of parents and professionals regarding the use of standing frames for children with cerebral palsy. Child Care Health Dev. 2018;44(2):195-202. https://doi.org/10.1111/cch.12505.
  24. Gericke T. Postural management for children with cerebral palsy: consensus statement. Dev Med Child Neurol. 2006;48(4):244. https://doi.org/10.1017/S0012162206000685.
  25. Bush S, Daniels N, Caulton J, et al. Guidance on assisted standing for children with cerebral palsy. APCP Journal. 2010;(2):3-10.
  26. Lyons EA, Jones DE, Swallow VM, Chandler C. An exploration of comfort and discomfort amongst children and young people with intellectual disabilities who depend on postural management equipment. J Appl Res Intellect Disabil. 2017;30(4):727-742. https://doi.org/10.1111/jar.12267.
  27. Hill S, Goldsmith L. Mobility, posture and comfort. Oxford: Wiley-Blackwell; 2009. P. 328–347.
  28. Palisano RJ, Shimmell LJ, Stewart D, et al. Mobility experiences of adolescents with cerebral palsy. Phys Occup Ther Pediatr. 2009;29(2):133-153. https://doi.org/10.1080/01942630902784746.
  29. Pountney TE, Mandy A, Green E, Gard PR. Hip subluxation and dislocation in cerebral palsy — a prospective study on the effectiveness of postural management programmes. Physiother Res Int. 2009;14(2):116-127. https://doi.org/10.1002/pri.434.

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Copyright (c) 2020 Koltsov A.A., Dzhomardly E.I., Kenis V.M., Lapkin Y.A.

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