A wearable gait analysis protocol to support the choice of the appropriate ankle-foot orthosis: A comparative assessment in children with Cerebral Palsy. (December 2019)

• Record Type: Journal Article
• Authors: Contini, Bruno Giuseppe; Bergamini, Elena; Alvini, Martina; Di Stanislao, Eugenio; Di Rosa, Giuseppe; Castelli, Enrico; Vannozzi, Giuseppe; Camomilla, Valentina
• Is Part Of: Clinical biomechanics. Volume 70(2019)
• Page Start: 177
• Page End: 185
• Publication Date: 2019-12
• Subjects: 10MWT 10-Meter Walk Test -- ACPT attenuation coefficient pelvic-trunk -- AFO ankle-foot orthosis -- AP antero-posterior -- CC cranio-caudal -- CP Cerebral Palsy -- GMFCS Gross Motor Function Classification System -- hAFO hinged ankle-foot orthosis -- iHR improved Harmonic Ratio -- OGS Observational Gait Scale -- MIMU Magneto-Inertial Measurement Unit -- ML medio-lateral -- RMS Root Mean Square -- RoM Range of Motion -- RoMP pelvic tilt Range of Motion -- RoMT trunk lateral bending Range of Motion -- RMS-PAP Pelvic Antero-Posterior Root Mean Square acceleration -- RMS-TML Trunk Medio-Lateral Root Mean Square acceleration -- sAFO solid ankle-foot orthosis -- SF cadence -- SL step length -- WS walking speed -- postS data obtained post use for sAFO -- postH data obtained post use for hAFO; Biomechanics -- Periodicals; Osteopathic medicine -- Periodicals; Biomechanics -- Periodicals; Osteopathic Medicine -- Periodicals; 612.76
• DOI: 10.1016/j.clinbiomech.2019.08.009
• Languages: English
• ISSNs: 0268-0033

Abstract

Abstract: Background: Cerebral Palsy is, nowadays, the most common cause of pediatric disabilities, particularly debilitating for daily living activities. While the adoption of ankle-foot orthoses is very well established as gait treatment, the choice of the most appropriate orthotic configuration is not strongly supported by scientific evidence. The aim of this study was to develop an instrumented assessment protocol based on wearable gait analysis to support clinicians in ankle-foot orthoses configuration selection. Methods: Ten children with spastic diplegic Cerebral Palsy were assessed (7 males, aged 4 to 11 years; all functionally classified as Gross Motor Function Classification System I or II, with clinical indication of conservative treatment through use of ankle-foot orthoses). They performed a 10Meter Walk Test in three conditions: barefoot and wearing alternatively a polypropylene hinged and solid ankle-foot orthosis accommodated in the same off-the-shelf shoe model, after 20 days of daily use of each configuration. An instrumented assessment protocol based on body-mounted magneto-inertial sensors was devised to derive spatio-temporal, gait stability and symmetry biomechanical parameters within an observational pre and post cross over design. Findings: The analysis at the individual level quantitatively revealed how different patients benefited differently from the two orthoses. No general indications were obtained in favour of or against a specific configuration for the sample as a whole. Interpretation: The proposed instrumented protocol represents a quantitative and useful tool to support the clinical selection of an appropriate orthotic treatment and, potentially, in evaluating its effectiveness. Highlights: An ecological gait assessment protocol based on inertial sensors was developed. The protocol was tested on a group of children with diplegic Cerebral Palsy. Clinically relevant spatio-temporal data, gait stability and symmetry were measured. Pictorial feedback integrates clinical observation with quantitative analysis. Potential is evidenced to support patient-specific ankle-foot orthoses selection.