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The clinical impact of orthotic correction of lower limb rotational deformities in children with cerebral palsy: a randomized controlled trial [with consumer summary]
Abd el-Kafy EM
Clinical Rehabilitation 2014 Oct;28(10):1004-1014
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: This study aimed to evaluate the effectiveness of a static ground reaction ankle foot orthosis and strapping system on improving gait parameters in children with spastic diplegic cerebral palsy. SETTING: The current study was conducted at the physical therapy faculty of Cairo University, Egypt. SUBJECTS: This study included 57 children of both sexes, aged 6 to 8 years. STUDY DESIGN: Three-armed randomized control trial. INTERVENTION: Participants in all groups received a traditional neuro-developmental physical therapy program that included standing and gait training exercises. Children in group A performed the training program without any orthotic management, in group B with the TheraTogs strapping system, and in group C with the TheraTogs strapping system and static ground reaction ankle foot orthoses. Children underwent treatment for two hours daily, except on weekends, for twelve successive weeks. MAIN MEASURE: Gait speed, cadence, stride length, and hip and knee flexion angles in the mid-stance phase were evaluated pre-and post-treatment using a three-dimensional motion analysis system (pre-reflex system). RESULTS: Statistically significant differences were recorded among the three groups post-treatment in gait speed, cadences, and stride length. The p-values for these variable differences were 0.03, 0.011, and 0.001 respectively. Significant post-treatment differences were also recorded for bilateral hip-and knee-flexion angles. For all measured parameters, better significant results were registered for group C than for the other groups. CONCLUSION: Orthotic intervention composed of a static ground reaction ankle foot orthosis combined with the TheraTogs strapping system improves gait more than conventional treatment with or without TheraTogs in children with spastic diplegic cerebral palsy.

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