Quantify Knee Flexion Crouch Gait Waveform Differences in Spastic Diplegic Cerebral Palsy with Ankle-Foot Orthoses
Date Issued
2011
Date
2011
Author(s)
Kao, Fu-Yuan
Abstract
Objective: Ankle-foot orthoses (AFOs) are designed to correct the abnormal gait pattern in patients with celebral palsy. There were many studies which used gait analysis to test various types of AFOs for CP patients in their kinematics and kinetics performance. Many studies thought of AFOs as treatment intervention could improve pathological joint movement especially for ankle joint. But most of past studies concluded that AFOs can not improve knee and hip joints in the lower extremity. This study would use principal component analysis(PCA) to quantify the dynamic gait waveform and compare different types of AFOs for cerebral palsy with crouch gait.
Methods: Nine spastic diplegic cerebral palsy patients with flexed knee gait (seven boys and two girls) anticipated in this study. Patients were recruited in this study, including those who had greater knee flexion angle (more than 10 degrees) in stance phase. There were three conditions including shoes only (SHOE), hinged ankle-foot orthoses (HAFO), and solid ankle-foot orthoses (SAFO) to test the biomechanical effects of AFOs. We collected kinematic and kinetic data to calculate joint angles, moments, joint powers, and use principal component analysis to analyze critical gait parameters. For enhancing comparisons between different orthotic conditions, All participants were separated into three groups depending on the pair of the orthotic intervention: (a) group 1: SHOE -HAFO (b) group 2: SHOE-SAFO (c) group 3: HAFO-SAFO.
Results: There were some significant differences between groups in the joint angles. The SAFOs condition decreased ankle dorsiflexion angle, knee flexion angle and hip flexion angle when comparing with the SHOE and the HAFOs conditons. But HAFOs condition revealed more power absorption as well as power generation in the late stance phase when comparing with the SHOE and the SAFOs conditions. And the HAFOs condition also increased ankle plantar flexion moment in stance phase when comparing with the SHOE condition.
Conclusion: The characteristic of the Principal component analysis could use fewer data to describe complex data structure effectively, especially in high homogeneous one or more conditions. Besides, principal component analysis considered the whole time period, not single gait event. The use of the PCA could analyze more objective and comprehensive in our study. And our study showed that SAFOs could decrease ankle dorsiflexion, knee flexion joint and hip flexion angle during gait. Although HAFOs could improve ankle joint angle, there were no significant improvement on knee flexion gait pattern. For spastic diplegic cerebral palsy patients with crouch gait, the results supported solid ankle-foot orthosis as effective treatments for patients with couch gait pattern.
Subjects
Cerebral palsy
crouch gait
Ankle-foot orthoses
Gait analysis
Principal component analysis
Type
thesis
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