Effects of dynamic elastomeric fabric orthoses in children with cerebral palsy: A single-blind randomized controlled trial.

Abstract

Background: The dynamic elastomeric fabric orthoses (DEFOs) are made of neoprene material, providing the right biomechanical alignment and afferent input in the trunk, pelvis, and extremities, potentially allowing individuals to actively participate in daily life.

Objective: The aim of this study was to investigate the effects of DEFOs applied to the lower trunk and pelvis, on balance, gait parameters, and pelvic symmetry in children with cerebral palsy (CP).

Study design: An evaluator-blinded randomized controlled trial.

Methods: Twenty-two children (7 girls, 15 boys) aged 4-10 years, with spastic CP, Gross Motor Function Classification System levels 1 and 2 were included. Thirteen children were randomly assigned to the control group (group 1) and 13 to the orthosis group (group 2), but 4 withdrew before treatment commenced. There were 10 children in group 1 and 12 in group 2. Both groups received a physiotherapy and rehabilitation program twice a week for 8 weeks. Children in group 2 received lower body and pelvis DEFOs in addition to physiotherapy and rehabilitation sessions. Dynamic elastomeric fabric orthoses wearing tolerance was gradually built up over the first week, until the child was wearing the DEFO 8 h per day. The pediatric balance scale and timed up and go test were used to assess balance, while gait parameters and pelvic kinematic values were evaluated using the BTS G-Walk, a wireless mini digital gait analysis system. All of the measurement tools used were validated for CP.

Results: Only stride length among the gait parameters changed in the group using DEFO compared with the group not using it (p = 0.035). There was no change in gait speed and cadence nor were there any differences in the balance scores between the groups. However, the pelvic tilt in the frontal plane of the pelvis improved significantly in the group using DEFOs compared with the group not using it (p = 0.014).

Conclusions: Dynamic elastomeric fabric orthoses used in the lower body and pelvis conferred superior stride length and the pelvic tilt in the frontal plane to conventional physiotherapy. All other outcomes were equally effective between groups.