Helle M Rasmussen1,2, Niels W Pedersen1,2, Søren Overgaard1,2, Lars K Hansen3, Ulrike Dunkhase-Heinl4, Yanko Petkov5, Vilhelm Engell1,2, Anders Holsgaard-Larsen1,2. 1. The Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark. 2. Department of Clinical Research, University of Southern Denmark, Odense, Denmark. 3. H.C. Andersen Children's Hospital, Odense University Hospital, Odense, Denmark. 4. Department of Paediatrics, Lillebaelt Hospital, Kolding, Denmark. 5. Department of Paediatrics, Hospital of Western Jutland, Esbjerg, Denmark.
Abstract
AIM: To test the hypothesis that improvements in gait and function following individualized interdisciplinary interventions consisting of physical therapy, orthotics, spasticity management, and orthopaedic surgery using instrumented gait analysis are superior to 'usual care' in children with cerebral palsy (CP). METHOD: This was a prospective, single-blind, parallel-group, randomized controlled trial investigating the effectiveness of interventions based on the use of gait analysis. Primary outcome was gait (Gait Deviation Index) and secondary outcomes were walking and patient-reported outcome measures of function, disability, and health-related quality of life. Follow-ups were done at 26 weeks (questionnaires) and at the primary end point of 52 weeks (all outcomes). RESULTS:Sixty participants with CP (39 males, 21 females, mean age 6y 10mo, standard deviation1y 3mo, range 5y-9y 1mo) in Gross Motor Function Classification System levels I or II, were randomized to interventions with or without gait analysis. No significant or clinically relevant between-group differences in change scores of the primary or secondary outcomes were found. The recommended categories of interventions were dominated by non-surgical interventions and were applied in 36% to 86% of the participants. INTERPRETATION: Interventions using gait analysis were not superior to 'usual care' on gait, walking, or patient-reported outcomes in a sample of relatively young and independently walking children with CP not expected to need surgery. WHAT THIS PAPER ADDS: Gait analysis in children with cerebral palsy in Gross Motor Function Classification System levels I or II recommends interdisciplinary interventions. Compliance to interventions recommended after gait analysis was low. No statistically significant advantages were identified for the intervention group versus the control group.
RCT Entities:
AIM: To test the hypothesis that improvements in gait and function following individualized interdisciplinary interventions consisting of physical therapy, orthotics, spasticity management, and orthopaedic surgery using instrumented gait analysis are superior to 'usual care' in children with cerebral palsy (CP). METHOD: This was a prospective, single-blind, parallel-group, randomized controlled trial investigating the effectiveness of interventions based on the use of gait analysis. Primary outcome was gait (Gait Deviation Index) and secondary outcomes were walking and patient-reported outcome measures of function, disability, and health-related quality of life. Follow-ups were done at 26 weeks (questionnaires) and at the primary end point of 52 weeks (all outcomes). RESULTS: Sixty participants with CP (39 males, 21 females, mean age 6y 10mo, standard deviation 1y 3mo, range 5y-9y 1mo) in Gross Motor Function Classification System levels I or II, were randomized to interventions with or without gait analysis. No significant or clinically relevant between-group differences in change scores of the primary or secondary outcomes were found. The recommended categories of interventions were dominated by non-surgical interventions and were applied in 36% to 86% of the participants. INTERPRETATION: Interventions using gait analysis were not superior to 'usual care' on gait, walking, or patient-reported outcomes in a sample of relatively young and independently walking children with CP not expected to need surgery. WHAT THIS PAPER ADDS: Gait analysis in children with cerebral palsy in Gross Motor Function Classification System levels I or II recommends interdisciplinary interventions. Compliance to interventions recommended after gait analysis was low. No statistically significant advantages were identified for the intervention group versus the control group.
Authors: Isabel Sinovas-Alonso; Diana Herrera-Valenzuela; Roberto Cano-de-la-Cuerda; Ana de Los Reyes-Guzmán; Antonio J Del-Ama; Ángel Gil-Agudo Journal: Front Hum Neurosci Date: 2022-04-04 Impact factor: 3.473
Authors: Diana Herrera-Valenzuela; Isabel Sinovas-Alonso; Juan C Moreno; Ángel Gil-Agudo; Antonio J Del-Ama Journal: Front Bioeng Biotechnol Date: 2022-07-06