Influence of using of articulated trunk hip orthosis on biomechanical parameters of walking in children with cerebral palsy

Authors:

Koltsov Andrey Anatolievich, the doctor in traumatology and orthopedics, PhD, the chief of First orthopedic department for children of Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Bestuzhevskaya street 50, 195067 Saint-Petersburg, Russian Federation.

Dzhomardly Elnur Isfandiiarovich, orthopedic surgeon, PhD – student of Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Bestuzhevskaya street 50, 195067 Saint-Petersburg, Russian Federation.

Marusin Nikita Vladimirovich, master’s degree in Technical physics, researcher of the Department of innovative technologies of Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Bestuzhevskaya street 50, 195067 Saint-Petersburg, Russian Federation. E-mail: nikita-orto@yandex.ru;fone +7 (921) 406-62-30

Belyanin Oleg Leonidovich, head of biomechanical studies of the musculoskeletal system of Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Bestuzhevskaya street 50, 195067 Saint-Petersburg, Russian Federation.

Annotation:

Introduction. Spastic forms of cerebral palsy is the most common form of the disorder, affecting around 80% of all people diagnosed. A feature of these forms is the earlier appearance of secondary orthopedic complications from the musculoskeletal system, which lead to violations of the function of support and movement. One of the important aspects in the correction of statodynamic disorders is the use of technical equipment of rehabilitation (TER) and, in particular, orthoses. However, the analysis of the use of articulated trunk hip orthosis is given in single works with often mutually exclusive conclusions, and therefore the study of the effect of orthoses of this design on the statodynamic function of the patient is significant and requires objective biomechanical control.

Aim. To assess the impact of articulated trunk hip orthosis on the biomechanical parameters of support and movement in children with spastic forms of cerebral palsy.

Materials and methods. The study was conducted in 27 patients with spastic forms of cerebral palsy aged 3 to 17 years using clinical, radiological, biomechanical and statistical methods. Biomechanical evaluation was carried out using the software and hardware complex Habilect. Statistical analysis of the results of the study was carried out using statistical analysis package Statistica 10 and Excel.

Results. Improvement of biomechanical parameters of walking using articulated trunk hip orthosis was observed in 24 patients (88.9%). In one patient (3.7%) with the level of motor activity GMFCS-2 marked the preservation of pathological internal rotation of the lower limb and revealed acyclic step length, in two patients (7.4%) with the level of motor activity GMFCS-3 marked increase in the severity of pathological reversal of the feet (external rotation), increased crouch syndrome.

Conclusion. Appointment of functional orthosis to disabled children with spastic forms of cerebral palsy with levels of motor activity GMFCS1-3 in the vast majority of cases provides improvement of the patient’s statodynamic function. The ambiguity of the results obtained for a number of parameters makes it expedient to continue the study on a larger sample of patients, taking into account age groups, prevailing deformations and other factors, including the use of additional methods of biomechanical control.

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