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: email@example.com;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.
In the heading: Original researches
Year: 2019 Volume: 1 Journal number: 2
Article type: scientific and practical
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.
1. Armand S., Decoulon G., Bonnefoy-Mazure A. (2016) Gait analysis in children with cerebral palsy. EFORT Open Rev, 1: 448-460. DOI: 10.1302/2058-5241.1.000052
2. Colver A., Fairhurst C., Pharoah PO. (2014) Cerebral palsy. Lancet, 383: 1240–1249.
3. Narayanan U.G. (2016) Lower Limb Deformity in Neuromuscular Disorders: Pathophysiology, Assessment, Goals, and Principles of Management. Pediatric Lower Limb Deformities, 267-269. DOI 10.1007/978-3-319-17097-8_17
4. Tolentino J., Talente G. (2016) Cerebral Palsy. Care of Adults with Chronic Childhood Conditions, 69-70. DOI 10.1007/978-3-319-43827-6_5
5. Verma H., Srivastava V., Semwal B.C. (2012) A review on cerebral palsy and its management. Journal of sciences, 2(2): 54-60.
6. Winter S. (2016) Cerebral Palsy. Health Care for People with Intellectual and Developmental Disabilities across the Lifespan, 931-948. DOI 10.1007/978-3-319-18096-0_8
7. Goodwin J., Colver A., Basu A., Crombie S. (2018) Understanding frame: A UK survey of parents and professionals regarding the use of standing frames for children with cerebral palsy. Child Care Health Dev, 44: 195-202. DOI 10.1111/cch.12505
8. Klochkova O.A., Kurenkov A.L., Kenis V.M. Formirovanie kontrakturpr i spasticheskix formax detskogo cerebral`nogo paralicha: voprosy` patogeneza [Development of contracture in spastic forms of cerebral palsy: pathogenesis and prevention]. Ortopediya, travmatologiya i vosstanovitel`naya xirurgiya detskogo vozrasta – Orthopedics, traumatology and plastic surgery of children’s age.2018; 6(1): 58-66. (In Russ) DOI 10.17816/PTORS6158-66
9. Solopova I.A., Moshonkina T.R., Umnov V.V. i dr. Nejroreabilitaciya pacientov s detskim cerebral`nym paralichom [Neurorehabilitation of Patients with Cerebral Palsy] Fiziologiya cheloveka – Human physiology,2015; 41(4): 448–454. (In Russ.) DOI: 10.7868/S0131164615040153
10. Rosa M.C.N., Roque A.G.G. (2016) Spasticity Effect in Cerebral Palsy Gait. Handbook of Human Motion, 2-15. DOI 10.1007/978-3-319-30808-1_55-1
11. Stephane Armand, Geraldo Decoulon, Alice Bonnefoy-Mazure. (2016) Gait analysis in children with cerebral palsy. Paediatrics, 1; 448.
12. Wingstrand Maria, Hagglung Gunnar, Rodby-Bousquet Elisabet. (2014) BMC Musculoskeletal Disorders, 1-7.
13. Kate Willoughby, Soon Ghee ANG, Pam Yhomason, H Kerr Graham. (2012) The impact of botulinum toxin A and abduction bracing on Long-term hip development in children with cerebral palsy. 54(8): 743-745.
14. Palisano R, Rosenbaum P, Walter S, Russell D et al. (1997) Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 39(4): 214-23.
15. Wood E, Rosenbaum P. (2000) The gross motor function classiﬁcation system for cerebral palsy: a study of reliability and stability over time. Dev Med Child Neurol, 42(5): 292–6.
16. Skvortsov D.V. Klinicheskij analiz dvizhenij. Аnaliz pokhodki [Clinical analysis of movements. Analysis of gait]. Ivanovo: Nauka Publ. «Incentive», 1996, 344 p. (In Russ.)
17. Bernshtejn, N.А. Issledovaniya po biodinamike khod’by, bega, pryzhka[Researches on biodynamics of walking, run, jump]. Moscow: Fizkul’turai sport – Physical culture and sport, 1940, 312 p.(In Russ.)