부산대학교 도서관

PURPOSE: Current literature focuses on the effect of orthotics, used in the management of individuals with cerebral palsy, on impairment level measures. The Standardized Walking Obstacle Course (SWOC), was developed to determine functional ambulation status by measuring stability and timeliness of gait in a natural and functional setting under different circumstances. The Pediatric Balance Scale (PBS), was modified from the Berg Balance Scale to measure balance in children as they perform a variety of functional tasks. The purpose of this study was to evaluate individuals with cerebral palsy with and without use of their orthotics using these functional measures, goal performance and subjective report. SUBJECTS: Eight children with cerebral palsy 6-18 years who regularly use orthotics for ambulation, had the ability to ambulate without an assistive device, follow simple instructions, and had no cardiopulmonary co-morbidity. METHODS: One group multiple measures design. For SWOC performance assignment was random for orthotic wear and conditions. Each participant walked the obstacle course: arms free, carrying a lunch tray with place setting, and wearing shaded glasses. The time, number of steps needed to negotiate the obstacle course, the number of stumbles and/or step off the course were tallied. For PBS performance assignment was random for orthotic wear. Each participant performed 14 tasks (i.e. turning in a circle, standing on one foot) of the PBS. Performance was graded using 0-4 scale for time to complete the task and quality of performance. ANALYSIS: Repeated measures ANOVA and Tukey's tests performed on time and number of steps data from the SWOC. Friedman ANOVA tests performed on number of step-offs and stumbles data from the SWOC. Wilcoxin Signed Rank Test performed on the data from the PBS. RESULTS: No significant difference for orthotics on or off on the PBS or for each condition of the SWOC. Significant difference noted carrying the tray versus hands free or wearing glasses on the SWOC. Goal performance and subjective report yielded responses inconsistent with the functional measures. CONCLUSIONS: No difference with or without orthotics on functional measures, decreased speed under certain conditions of the SWOC, higher goal achievement with orthotics off and preference for no orthotics. The SWOC and PBS in combination with goal performance and subjective report are appropriate measures of functional ambulation.
Kott, K, Held, S; Departments of Physical Therapy SUNY Health Science Center Syracuse, New York and Daemen College, Amherst New [...]