Splint the efficacy of orthotic management in rest to prevent equinus in children with cerebral palsy, a randomised controlled trial 英文参考文献.docVIP

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Splint the efficacy of orthotic management in rest to prevent equinus in children with cerebral palsy, a randomised controlled trial 英文参考文献.doc

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Splint the efficacy of orthotic management in rest to prevent equinus in children with cerebral palsy, a randomised controlled trial 英文参考文献

Maasetal.BMCPediatrics2012,12:38 /1471-2431/12/38 STUDY PROTOCOL OpenAccess Splint:theefficacyoforthoticmanagementin resttopreventequinusinchildrenwithcerebral palsy,arandomisedcontrolledtrial JosinaCMaas1*?,AnnetJDallmeijer1?,PeterAHuijing2?,JaniceEBrunstrom-Hernandez3,PetraJvanKampen4, RichardTJaspers2?andJulesGBecher1? Abstract Background:Rangeofmotiondeficitsofthelowerextremityoccurinaboutthehalfofthechildrenwithspastic cerebralpalsy(CP).Overtime,theseimpairmentscancausejointdeformitiesanddeviationsinthechildren’ sgait pattern,leadingtolimitationsinmoblity.Preventingalossofrangeofmotionisimportantinordertoreduce secondaryactivitylimitationsandjointdeformities.Sustainedmusclestretch,imposedbyorthoticmanagementin rest,mightbeaneffectivemethodofpreventingadecreaseinrangeofmotion.However,nocontrolledstudyhas beenperformed. Methods:Asingleblindrandomisedcontrolledtrialwillbeperformedin66childrenwithspasticCP,dividedover threegroupswitheach22participants.Twogroupswillbetreatedfor1yearwithorthosestopreventadecreasein rangeofmotionintheankle(eitherwithstaticordynamicknee-ankle-foot-orthoses)andathirdgroupwillbeincluded asacontrolgroupandwillreceiveusualcare(physicaltherapy,manualstretching).Measurementswillbeperformedat baselineandat3,6,9and12monthsaftertreatmentallocation.Theprimaryoutcomemeasurewillbeankle dorsiflexionatfullkneeextension,measuredwithacustomdesignedhandhelddynamometer.Secondaryoutcome measureswillbei)ankleandkneeflexionduringgaitandii)grossmotorfunction.Furthermore,togainmoreinsightin theworkingmechanismoftheorthoticmanagementinrest,morphologicalparameterslikeachillestendonlength, musclebellylength,musclefasciclelength,musclephysiologicalcrosssectionalarealengthandfasciclepennation anglewillbemeasuredinasubgroupof18participantsusinga3Dimagingtechnique. Discussion:Thisrandomisedcontrolledtrialwillprovidemoreinsightintotheefficacyoforthoticmanagementinrest andtheworkingmechanismsbehindthistreatment.Theresultsofthisstudycouldleadtoimprovedtreatments. Tr