Evaluation of motor skill improvement by use of variable abduction hip orthosis in children with cerebral palsy and lower limb spasticity

Variable abduction hip orthosis (VAHO) has been applied for more than 20 years. The manufacturer recommends its application to improve motor skills in children with spastic palsy of lower limbs of any aetiology and to prevent hip displacement in cerebral palsy (CP) children but there are no published clinical studies to confirm this statement. The objectives of the study were to evaluate the efficacy of orthotic management in CP children with lower limb spasticity by use of VAHO through clinical assessment parameters that describe motor skills; and to determine objectively the difference in the manifestation of motor disorder without VAHO, with VAHO, and after six months of using VAHO. Evaluation was performed by clinical examination, filling out a questionnaire to evaluate motor skills using VAHO (the questionnaire is part of the instructions for using VAHO), and analysis of the data obtained. In 10 children (six boys and four girls, age 4-12 years) we observed the following parameters: improvement of the child’s sitting, posture, walking, scissoring gait and walking distance in meters without orthosis, using VAHO and after 6 months of using VAHO. Statistical analysis was performed by Wilcoxon test of matched pairs. In 80% of the children, the indication for VAHO application was justified because it led to improvement in motor skills, whereas 20% of the children gave up using VAHO. We found a statistically significant difference in motor skill improvement in children using VAHO compared to motor skills without VAHO, which was also evident after 6 months of its application. Walking distance was even better after 6 months of using VAHO. In conclusion, study results confirmed the efficacy of VAHO application and improvement of motor skills in CP children with lower limb spasticity. There is quite a small number of published papers assessing the efficacy of VAHO use and this study can help clinicians opting for orthotic solution in children with lower limb spasticity. Longer monitoring in a larger group of users is warranted to examine the effect of VAHO more closely. Key words: HIP; FOOT ORTHOSES; CEREBRAL PALSY; PARALYSIS
Category: -> Uncategorised
Volume: Vol. 63, No 3, july - september 2019
Authors: Đurđica Kesak-Ursić
Reference work: Paediatr Croat. 2019;63:113-8
DOI: http://dx.doi.org/10.13112/PC.2019.26

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