splint the efficacy of orthotic management in rest to prevent equinus in children with cerebral palsy, a randomised controlled trial夹板的功效其他矫正的管理防止马蹄足在脑瘫患儿,随机对照试验.pdfVIP

Maas et al. BMC Pediatrics 2012, 12:38 /1471-2431/12/38 STUDY PROTOCOL Open Access Splint: the efficacy of orthotic management in rest to prevent equinus in children with cerebral palsy, a randomised controlled trial 1*† 1† 2† 3 4 Josina C Maas , Annet J Dallmeijer , Peter A Huijing , Janice E Brunstrom-Hernandez , Petra J van Kampen , Richard T Jaspers2† and Jules G Becher1† Abstract Background: Range of motion deficits of the lower extremity occur in about the half of the children with spastic cerebral palsy (CP). Over time, these impairments can cause joint deformities and deviations in the children’s gait pattern, leading to limitations in moblity. Preventing a loss of range of motion is important in order to reduce secondary activity limitations and joint deformities. Sustained muscle stretch, imposed by orthotic management in rest, might be an effective method of preventing a decrease in range of motion. However, no controlled study has been performed. Methods: A single blind randomised controlled trial will be performed in 66 children with spastic CP, divided over three groups with each 22 participants. Two groups will be treated for 1 year with orthoses to prevent a decrease in range of motion in the ankle (either with static or dynamic knee-ankle-foot-orthoses) and a third group will be included as a control group and will receive usual care (physical therapy, manual stretching). Measurements will be performed at baseline and at 3, 6, 9 and 12 months after treatment allocation. The primary outcome measure will be ankle dorsiflexion at full knee extension, measured with a custom designed hand held dynamometer. Secondary outcome measures will be i) ankle an