Does eliminating toe-fixing pattern improve gait pattern in children with cerebral palsy?

Pao Yue-kong Library Electronic Theses Database

Does eliminating toe-fixing pattern improve gait pattern in children with cerebral palsy?

 

Author: Chan, Wai-ting Tina
Title: Does eliminating toe-fixing pattern improve gait pattern in children with cerebral palsy?
Year: 2004
Subject: Hong Kong Polytechnic University -- Dissertations
Cerebral palsied children -- Rehabilitation
Gait in humans
Walking -- Physiological aspects
Department: Dept. of Rehabilitation Sciences
Pages: ix, 50 leaves : col. ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1772693
URI: http://theses.lib.polyu.edu.hk/handle/200/1828
Abstract: Toe-fixing pattern have been observed to be a compensatory strategy for children with cerebral palsy to gain body stability in the upright position. Reducing the toe-fixing pattern with sponge separators in the toes may force these children to develop and practice normal postural mechanisms for stability .The aim of this study was to investigate the immediate and over-time effects in their standing posture and walking pattern before and after reducing this inappropriate compensatory strategy in the toes. A randomized controlled trial was be conducted, involving 24 school-aged subjects with cerebral palsy (13 male, 11 females, mean age 10 years, SD 2.98 years, aged 6 to 15) who are ambulatory (11 aided walkers, 13 independent walkers). Subjects were randomly assigned into control and experimental group. The design involved a pretest and a posttest, which were at 3 weeks apart. Measurements in standing and walking were taken. Two conditions (without sponges and with sponges) were tested in both assessments. One child dropped out of the study. In the control group (n=12), subjects continued to receive their routine physiotherapy treatment and daily walking practice. In the experimental group (n=12), subjects carried out the same activities with sponge separators in the toes, wearing them for 9 hours a day. Heel distance and foot angle in standing, gait velocity and step length were measured before and after treatment for both groups. No statistically significant regression was found immediately after application of toe sponges. After 3 weeks of treatment, 8 of the 12 subjects were observed to have increasing tends in velocity and step length, as well as improved movement patterns during walking qualitatively. However, no statistically significant improvement was found the experimental group when compared with the control group. Using toe sponges to eliminate toe-fixing patterns may be considered as an adjunct treatment strategy, but further research is required, using a more homogeneous group and a longer intervention period.

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