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2021 (1)

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Dissertation
Orthotic Management in Cerebral Palsy: Knee, Hip and Spinal orthoses
Authors: --- --- ---
Year: 2021 Publisher: Leuven KU Leuven. Faculteit Geneeskunde

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Abstract

Background: Cerebral palsy is a common motor disorder in children, resulting in many musculoskeletal deformities and physical disability. Knee flexion contractures, hip dislocation and scoliosis are main symptoms caused by both changes to the muscles themselves and changes in the neural drive to muscles. It affects mobility and independence with crouch gait, pain, and trunk and head imbalance as consequence. As conservative treatment in cerebral palsy, orthoses are used to correct and prevent these deformities, to facilitate carrying, and to improve the efficiency of daily activities such as sitting, lying down, standing, and walking. Objectives: To review the use of knee, hip, and spinal orthoses as treatment in children with cerebral palsy. Methods: A systematic review was conducted, retrieved by scanning databases as PubMed and Cochrane Library, with exclusion criteria: ankle-foot orthoses and other interventional therapies. Results: Knee orthoses seem to give an improvement on flexion contractures of the hamstrings, though we only found a few studies concerning knee orthoses. Small amounts of evidence support the use hip orthoses as treatment of cerebral palsy, since we found no great effect on Gross Motor Function (GMF) and hip displacement rates. Concerning spinal orthoses, an improvement in sitting stability and head and trunk control was reported. However, the expected effect on progression on spinal curvature could not be confirmed. Conclusion: Further research on the use and effect of orthoses as treatment in children with cerebral palsy is needed to create an overview of when benefits and effects of a certain orthosis outweigh the discomfort and costs.

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