Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study

<p<Abstract</p< <p<Background</p< <p<Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs), are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP), walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost) of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations.</p< <p<The primary aim of this study is to evaluate the effect of FROs optimised for ankle stiffness on the walking energy cost in children with SCP, compared to walking with shoes alone. In addition, effects on various secondary outcome measures will be evaluated in order to identify possible working mechanisms and potential predictors of FRO treatment success.</p< <p<Method/Design</p< <p<A pre-post experimental study design will include 32 children with SCP, walking with excessive knee flexion in midstance, recruited from our university hospital and affiliated rehabilitation centres. All participants will receive a newly designed FRO, allowing ankle stiffness to be varied into three configurations by means of a hinge. Gait biomechanics will be assessed for each FRO configuration. The FRO that results in the greatest reduction in knee flexion during the single stance phase will be selected as the subject’s optimal FRO. Subsequently, the effects of wearing this optimal FRO will be evaluated after 12–20 weeks. The primary study parameter will be walking energy cost, with the most important secondary outcomes being intensity of participation, daily activity, walking speed and gait biomechanics.</p< <p<Discussion</p< <p<The AFO-CP trial will be the first experimental study to evaluate the effect of individually optimised FROs on mobility and participation. The evaluation will include outcome measures at all levels of the International Classification of Functioning, Disability and Health, providing a unique set of data with which to assess relationships between outcome measures. This will give insights into working mechanisms of FROs and will help to identify predictors of treatment success, both of which will contribute to improving FRO treatment in SCP in term.</p< <p<Trial registration</p< <p<This study is registered in the Dutch Trial Register as NTR3418.</p< Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Kerkum Yvette L [verfasserIn] Harlaar Jaap [verfasserIn] Buizer Annemieke I [verfasserIn] van den Noort Josien C [verfasserIn] Becher Jules G [verfasserIn] Brehm Merel-Anne [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2013

Schlagwörter:	Cerebral Palsy Pediatrics Orthotic devices Ankle foot orthoses Intervention studies Treatment effectiveness Mobility Participation Gait

Übergeordnetes Werk:	In: BMC Pediatrics - BMC, 2003, 13(2013), 1, p 17
Übergeordnetes Werk:	volume:13 ; year:2013 ; number:1, p 17

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/1471-2431-13-17

Katalog-ID:	DOAJ026672537

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allfields	10.1186/1471-2431-13-17 doi (DE-627)DOAJ026672537 (DE-599)DOAJ35583b4718f445378f61f361851a3120 DE-627 ger DE-627 rakwb eng RJ1-570 Kerkum Yvette L verfasserin aut Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <p<Abstract</p< <p<Background</p< <p<Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs), are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP), walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost) of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations.</p< <p<The primary aim of this study is to evaluate the effect of FROs optimised for ankle stiffness on the walking energy cost in children with SCP, compared to walking with shoes alone. In addition, effects on various secondary outcome measures will be evaluated in order to identify possible working mechanisms and potential predictors of FRO treatment success.</p< <p<Method/Design</p< <p<A pre-post experimental study design will include 32 children with SCP, walking with excessive knee flexion in midstance, recruited from our university hospital and affiliated rehabilitation centres. All participants will receive a newly designed FRO, allowing ankle stiffness to be varied into three configurations by means of a hinge. Gait biomechanics will be assessed for each FRO configuration. The FRO that results in the greatest reduction in knee flexion during the single stance phase will be selected as the subject’s optimal FRO. Subsequently, the effects of wearing this optimal FRO will be evaluated after 12–20 weeks. The primary study parameter will be walking energy cost, with the most important secondary outcomes being intensity of participation, daily activity, walking speed and gait biomechanics.</p< <p<Discussion</p< <p<The AFO-CP trial will be the first experimental study to evaluate the effect of individually optimised FROs on mobility and participation. The evaluation will include outcome measures at all levels of the International Classification of Functioning, Disability and Health, providing a unique set of data with which to assess relationships between outcome measures. This will give insights into working mechanisms of FROs and will help to identify predictors of treatment success, both of which will contribute to improving FRO treatment in SCP in term.</p< <p<Trial registration</p< <p<This study is registered in the Dutch Trial Register as NTR3418.</p< Cerebral Palsy Pediatrics Orthotic devices Ankle foot orthoses Intervention studies Treatment effectiveness Mobility Participation Gait Harlaar Jaap verfasserin aut Buizer Annemieke I verfasserin aut van den Noort Josien C verfasserin aut Becher Jules G verfasserin aut Brehm Merel-Anne verfasserin aut In BMC Pediatrics BMC, 2003 13(2013), 1, p 17 (DE-627)326643621 (DE-600)2041342-7 14712431 nnns volume:13 year:2013 number:1, p 17 https://doi.org/10.1186/1471-2431-13-17 kostenfrei https://doaj.org/article/35583b4718f445378f61f361851a3120 kostenfrei http://www.biomedcentral.com/1471-2431/13/17 kostenfrei https://doaj.org/toc/1471-2431 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2013 1, p 17
spelling	10.1186/1471-2431-13-17 doi (DE-627)DOAJ026672537 (DE-599)DOAJ35583b4718f445378f61f361851a3120 DE-627 ger DE-627 rakwb eng RJ1-570 Kerkum Yvette L verfasserin aut Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <p<Abstract</p< <p<Background</p< <p<Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs), are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP), walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost) of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations.</p< <p<The primary aim of this study is to evaluate the effect of FROs optimised for ankle stiffness on the walking energy cost in children with SCP, compared to walking with shoes alone. In addition, effects on various secondary outcome measures will be evaluated in order to identify possible working mechanisms and potential predictors of FRO treatment success.</p< <p<Method/Design</p< <p<A pre-post experimental study design will include 32 children with SCP, walking with excessive knee flexion in midstance, recruited from our university hospital and affiliated rehabilitation centres. All participants will receive a newly designed FRO, allowing ankle stiffness to be varied into three configurations by means of a hinge. Gait biomechanics will be assessed for each FRO configuration. The FRO that results in the greatest reduction in knee flexion during the single stance phase will be selected as the subject’s optimal FRO. Subsequently, the effects of wearing this optimal FRO will be evaluated after 12–20 weeks. The primary study parameter will be walking energy cost, with the most important secondary outcomes being intensity of participation, daily activity, walking speed and gait biomechanics.</p< <p<Discussion</p< <p<The AFO-CP trial will be the first experimental study to evaluate the effect of individually optimised FROs on mobility and participation. The evaluation will include outcome measures at all levels of the International Classification of Functioning, Disability and Health, providing a unique set of data with which to assess relationships between outcome measures. This will give insights into working mechanisms of FROs and will help to identify predictors of treatment success, both of which will contribute to improving FRO treatment in SCP in term.</p< <p<Trial registration</p< <p<This study is registered in the Dutch Trial Register as NTR3418.</p< Cerebral Palsy Pediatrics Orthotic devices Ankle foot orthoses Intervention studies Treatment effectiveness Mobility Participation Gait Harlaar Jaap verfasserin aut Buizer Annemieke I verfasserin aut van den Noort Josien C verfasserin aut Becher Jules G verfasserin aut Brehm Merel-Anne verfasserin aut In BMC Pediatrics BMC, 2003 13(2013), 1, p 17 (DE-627)326643621 (DE-600)2041342-7 14712431 nnns volume:13 year:2013 number:1, p 17 https://doi.org/10.1186/1471-2431-13-17 kostenfrei https://doaj.org/article/35583b4718f445378f61f361851a3120 kostenfrei http://www.biomedcentral.com/1471-2431/13/17 kostenfrei https://doaj.org/toc/1471-2431 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2013 1, p 17
allfields_unstemmed	10.1186/1471-2431-13-17 doi (DE-627)DOAJ026672537 (DE-599)DOAJ35583b4718f445378f61f361851a3120 DE-627 ger DE-627 rakwb eng RJ1-570 Kerkum Yvette L verfasserin aut Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <p<Abstract</p< <p<Background</p< <p<Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs), are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP), walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost) of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations.</p< <p<The primary aim of this study is to evaluate the effect of FROs optimised for ankle stiffness on the walking energy cost in children with SCP, compared to walking with shoes alone. In addition, effects on various secondary outcome measures will be evaluated in order to identify possible working mechanisms and potential predictors of FRO treatment success.</p< <p<Method/Design</p< <p<A pre-post experimental study design will include 32 children with SCP, walking with excessive knee flexion in midstance, recruited from our university hospital and affiliated rehabilitation centres. All participants will receive a newly designed FRO, allowing ankle stiffness to be varied into three configurations by means of a hinge. Gait biomechanics will be assessed for each FRO configuration. The FRO that results in the greatest reduction in knee flexion during the single stance phase will be selected as the subject’s optimal FRO. Subsequently, the effects of wearing this optimal FRO will be evaluated after 12–20 weeks. The primary study parameter will be walking energy cost, with the most important secondary outcomes being intensity of participation, daily activity, walking speed and gait biomechanics.</p< <p<Discussion</p< <p<The AFO-CP trial will be the first experimental study to evaluate the effect of individually optimised FROs on mobility and participation. The evaluation will include outcome measures at all levels of the International Classification of Functioning, Disability and Health, providing a unique set of data with which to assess relationships between outcome measures. This will give insights into working mechanisms of FROs and will help to identify predictors of treatment success, both of which will contribute to improving FRO treatment in SCP in term.</p< <p<Trial registration</p< <p<This study is registered in the Dutch Trial Register as NTR3418.</p< Cerebral Palsy Pediatrics Orthotic devices Ankle foot orthoses Intervention studies Treatment effectiveness Mobility Participation Gait Harlaar Jaap verfasserin aut Buizer Annemieke I verfasserin aut van den Noort Josien C verfasserin aut Becher Jules G verfasserin aut Brehm Merel-Anne verfasserin aut In BMC Pediatrics BMC, 2003 13(2013), 1, p 17 (DE-627)326643621 (DE-600)2041342-7 14712431 nnns volume:13 year:2013 number:1, p 17 https://doi.org/10.1186/1471-2431-13-17 kostenfrei https://doaj.org/article/35583b4718f445378f61f361851a3120 kostenfrei http://www.biomedcentral.com/1471-2431/13/17 kostenfrei https://doaj.org/toc/1471-2431 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2013 1, p 17
allfieldsGer	10.1186/1471-2431-13-17 doi (DE-627)DOAJ026672537 (DE-599)DOAJ35583b4718f445378f61f361851a3120 DE-627 ger DE-627 rakwb eng RJ1-570 Kerkum Yvette L verfasserin aut Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <p<Abstract</p< <p<Background</p< <p<Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs), are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP), walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost) of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations.</p< <p<The primary aim of this study is to evaluate the effect of FROs optimised for ankle stiffness on the walking energy cost in children with SCP, compared to walking with shoes alone. In addition, effects on various secondary outcome measures will be evaluated in order to identify possible working mechanisms and potential predictors of FRO treatment success.</p< <p<Method/Design</p< <p<A pre-post experimental study design will include 32 children with SCP, walking with excessive knee flexion in midstance, recruited from our university hospital and affiliated rehabilitation centres. All participants will receive a newly designed FRO, allowing ankle stiffness to be varied into three configurations by means of a hinge. Gait biomechanics will be assessed for each FRO configuration. The FRO that results in the greatest reduction in knee flexion during the single stance phase will be selected as the subject’s optimal FRO. Subsequently, the effects of wearing this optimal FRO will be evaluated after 12–20 weeks. The primary study parameter will be walking energy cost, with the most important secondary outcomes being intensity of participation, daily activity, walking speed and gait biomechanics.</p< <p<Discussion</p< <p<The AFO-CP trial will be the first experimental study to evaluate the effect of individually optimised FROs on mobility and participation. The evaluation will include outcome measures at all levels of the International Classification of Functioning, Disability and Health, providing a unique set of data with which to assess relationships between outcome measures. This will give insights into working mechanisms of FROs and will help to identify predictors of treatment success, both of which will contribute to improving FRO treatment in SCP in term.</p< <p<Trial registration</p< <p<This study is registered in the Dutch Trial Register as NTR3418.</p< Cerebral Palsy Pediatrics Orthotic devices Ankle foot orthoses Intervention studies Treatment effectiveness Mobility Participation Gait Harlaar Jaap verfasserin aut Buizer Annemieke I verfasserin aut van den Noort Josien C verfasserin aut Becher Jules G verfasserin aut Brehm Merel-Anne verfasserin aut In BMC Pediatrics BMC, 2003 13(2013), 1, p 17 (DE-627)326643621 (DE-600)2041342-7 14712431 nnns volume:13 year:2013 number:1, p 17 https://doi.org/10.1186/1471-2431-13-17 kostenfrei https://doaj.org/article/35583b4718f445378f61f361851a3120 kostenfrei http://www.biomedcentral.com/1471-2431/13/17 kostenfrei https://doaj.org/toc/1471-2431 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2013 1, p 17
allfieldsSound	10.1186/1471-2431-13-17 doi (DE-627)DOAJ026672537 (DE-599)DOAJ35583b4718f445378f61f361851a3120 DE-627 ger DE-627 rakwb eng RJ1-570 Kerkum Yvette L verfasserin aut Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <p<Abstract</p< <p<Background</p< <p<Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs), are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP), walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost) of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations.</p< <p<The primary aim of this study is to evaluate the effect of FROs optimised for ankle stiffness on the walking energy cost in children with SCP, compared to walking with shoes alone. In addition, effects on various secondary outcome measures will be evaluated in order to identify possible working mechanisms and potential predictors of FRO treatment success.</p< <p<Method/Design</p< <p<A pre-post experimental study design will include 32 children with SCP, walking with excessive knee flexion in midstance, recruited from our university hospital and affiliated rehabilitation centres. All participants will receive a newly designed FRO, allowing ankle stiffness to be varied into three configurations by means of a hinge. Gait biomechanics will be assessed for each FRO configuration. The FRO that results in the greatest reduction in knee flexion during the single stance phase will be selected as the subject’s optimal FRO. Subsequently, the effects of wearing this optimal FRO will be evaluated after 12–20 weeks. The primary study parameter will be walking energy cost, with the most important secondary outcomes being intensity of participation, daily activity, walking speed and gait biomechanics.</p< <p<Discussion</p< <p<The AFO-CP trial will be the first experimental study to evaluate the effect of individually optimised FROs on mobility and participation. The evaluation will include outcome measures at all levels of the International Classification of Functioning, Disability and Health, providing a unique set of data with which to assess relationships between outcome measures. This will give insights into working mechanisms of FROs and will help to identify predictors of treatment success, both of which will contribute to improving FRO treatment in SCP in term.</p< <p<Trial registration</p< <p<This study is registered in the Dutch Trial Register as NTR3418.</p< Cerebral Palsy Pediatrics Orthotic devices Ankle foot orthoses Intervention studies Treatment effectiveness Mobility Participation Gait Harlaar Jaap verfasserin aut Buizer Annemieke I verfasserin aut van den Noort Josien C verfasserin aut Becher Jules G verfasserin aut Brehm Merel-Anne verfasserin aut In BMC Pediatrics BMC, 2003 13(2013), 1, p 17 (DE-627)326643621 (DE-600)2041342-7 14712431 nnns volume:13 year:2013 number:1, p 17 https://doi.org/10.1186/1471-2431-13-17 kostenfrei https://doaj.org/article/35583b4718f445378f61f361851a3120 kostenfrei http://www.biomedcentral.com/1471-2431/13/17 kostenfrei https://doaj.org/toc/1471-2431 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2013 1, p 17
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source	In BMC Pediatrics 13(2013), 1, p 17 volume:13 year:2013 number:1, p 17
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topic_facet	Cerebral Palsy Pediatrics Orthotic devices Ankle foot orthoses Intervention studies Treatment effectiveness Mobility Participation Gait
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authorswithroles_txt_mv	Kerkum Yvette L @@aut@@ Harlaar Jaap @@aut@@ Buizer Annemieke I @@aut@@ van den Noort Josien C @@aut@@ Becher Jules G @@aut@@ Brehm Merel-Anne @@aut@@
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topic_title	RJ1-570 Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study Cerebral Palsy Pediatrics Orthotic devices Ankle foot orthoses Intervention studies Treatment effectiveness Mobility Participation Gait
topic	misc RJ1-570 misc Cerebral Palsy misc Pediatrics misc Orthotic devices misc Ankle foot orthoses misc Intervention studies misc Treatment effectiveness misc Mobility misc Participation misc Gait
topic_unstemmed	misc RJ1-570 misc Cerebral Palsy misc Pediatrics misc Orthotic devices misc Ankle foot orthoses misc Intervention studies misc Treatment effectiveness misc Mobility misc Participation misc Gait
topic_browse	misc RJ1-570 misc Cerebral Palsy misc Pediatrics misc Orthotic devices misc Ankle foot orthoses misc Intervention studies misc Treatment effectiveness misc Mobility misc Participation misc Gait
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title	Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study
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title_full	Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study
author_sort	Kerkum Yvette L
journal	BMC Pediatrics
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author_browse	Kerkum Yvette L Harlaar Jaap Buizer Annemieke I van den Noort Josien C Becher Jules G Brehm Merel-Anne
container_volume	13
class	RJ1-570
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author-letter	Kerkum Yvette L
doi_str_mv	10.1186/1471-2431-13-17
author2-role	verfasserin
title_sort	optimising ankle foot orthoses for children with cerebral palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the afo-cp study
callnumber	RJ1-570
title_auth	Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study
abstract	<p<Abstract</p< <p<Background</p< <p<Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs), are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP), walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost) of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations.</p< <p<The primary aim of this study is to evaluate the effect of FROs optimised for ankle stiffness on the walking energy cost in children with SCP, compared to walking with shoes alone. In addition, effects on various secondary outcome measures will be evaluated in order to identify possible working mechanisms and potential predictors of FRO treatment success.</p< <p<Method/Design</p< <p<A pre-post experimental study design will include 32 children with SCP, walking with excessive knee flexion in midstance, recruited from our university hospital and affiliated rehabilitation centres. All participants will receive a newly designed FRO, allowing ankle stiffness to be varied into three configurations by means of a hinge. Gait biomechanics will be assessed for each FRO configuration. The FRO that results in the greatest reduction in knee flexion during the single stance phase will be selected as the subject’s optimal FRO. Subsequently, the effects of wearing this optimal FRO will be evaluated after 12–20 weeks. The primary study parameter will be walking energy cost, with the most important secondary outcomes being intensity of participation, daily activity, walking speed and gait biomechanics.</p< <p<Discussion</p< <p<The AFO-CP trial will be the first experimental study to evaluate the effect of individually optimised FROs on mobility and participation. The evaluation will include outcome measures at all levels of the International Classification of Functioning, Disability and Health, providing a unique set of data with which to assess relationships between outcome measures. This will give insights into working mechanisms of FROs and will help to identify predictors of treatment success, both of which will contribute to improving FRO treatment in SCP in term.</p< <p<Trial registration</p< <p<This study is registered in the Dutch Trial Register as NTR3418.</p<
abstractGer	<p<Abstract</p< <p<Background</p< <p<Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs), are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP), walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost) of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations.</p< <p<The primary aim of this study is to evaluate the effect of FROs optimised for ankle stiffness on the walking energy cost in children with SCP, compared to walking with shoes alone. In addition, effects on various secondary outcome measures will be evaluated in order to identify possible working mechanisms and potential predictors of FRO treatment success.</p< <p<Method/Design</p< <p<A pre-post experimental study design will include 32 children with SCP, walking with excessive knee flexion in midstance, recruited from our university hospital and affiliated rehabilitation centres. All participants will receive a newly designed FRO, allowing ankle stiffness to be varied into three configurations by means of a hinge. Gait biomechanics will be assessed for each FRO configuration. The FRO that results in the greatest reduction in knee flexion during the single stance phase will be selected as the subject’s optimal FRO. Subsequently, the effects of wearing this optimal FRO will be evaluated after 12–20 weeks. The primary study parameter will be walking energy cost, with the most important secondary outcomes being intensity of participation, daily activity, walking speed and gait biomechanics.</p< <p<Discussion</p< <p<The AFO-CP trial will be the first experimental study to evaluate the effect of individually optimised FROs on mobility and participation. The evaluation will include outcome measures at all levels of the International Classification of Functioning, Disability and Health, providing a unique set of data with which to assess relationships between outcome measures. This will give insights into working mechanisms of FROs and will help to identify predictors of treatment success, both of which will contribute to improving FRO treatment in SCP in term.</p< <p<Trial registration</p< <p<This study is registered in the Dutch Trial Register as NTR3418.</p<
abstract_unstemmed	<p<Abstract</p< <p<Background</p< <p<Ankle-Foot-Orthoses with a ventral shell, also known as Floor Reaction Orthoses (FROs), are often used to reduce gait-related problems in children with spastic cerebral palsy (SCP), walking with excessive knee flexion. However, current evidence for the effectiveness (e.g. in terms of walking energy cost) of FROs is both limited and inconclusive. Much of this ambiguity may be due to a mismatch between the FRO ankle stiffness and the patient’s gait deviations.</p< <p<The primary aim of this study is to evaluate the effect of FROs optimised for ankle stiffness on the walking energy cost in children with SCP, compared to walking with shoes alone. In addition, effects on various secondary outcome measures will be evaluated in order to identify possible working mechanisms and potential predictors of FRO treatment success.</p< <p<Method/Design</p< <p<A pre-post experimental study design will include 32 children with SCP, walking with excessive knee flexion in midstance, recruited from our university hospital and affiliated rehabilitation centres. All participants will receive a newly designed FRO, allowing ankle stiffness to be varied into three configurations by means of a hinge. Gait biomechanics will be assessed for each FRO configuration. The FRO that results in the greatest reduction in knee flexion during the single stance phase will be selected as the subject’s optimal FRO. Subsequently, the effects of wearing this optimal FRO will be evaluated after 12–20 weeks. The primary study parameter will be walking energy cost, with the most important secondary outcomes being intensity of participation, daily activity, walking speed and gait biomechanics.</p< <p<Discussion</p< <p<The AFO-CP trial will be the first experimental study to evaluate the effect of individually optimised FROs on mobility and participation. The evaluation will include outcome measures at all levels of the International Classification of Functioning, Disability and Health, providing a unique set of data with which to assess relationships between outcome measures. This will give insights into working mechanisms of FROs and will help to identify predictors of treatment success, both of which will contribute to improving FRO treatment in SCP in term.</p< <p<Trial registration</p< <p<This study is registered in the Dutch Trial Register as NTR3418.</p<
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title_short	Optimising Ankle Foot Orthoses for children with Cerebral Palsy walking with excessive knee flexion to improve their mobility and participation; protocol of the AFO-CP study
url	https://doi.org/10.1186/1471-2431-13-17 https://doaj.org/article/35583b4718f445378f61f361851a3120 http://www.biomedcentral.com/1471-2431/13/17 https://doaj.org/toc/1471-2431
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author2	Harlaar Jaap Buizer Annemieke I van den Noort Josien C Becher Jules G Brehm Merel-Anne
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