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Evaluating the efficacy of two types of AFOs on gait characteristics in children with CP
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e u r o p e a n j o u r n a l o f p a e d i a t r i c n e u r o l o g y 2 1 ( 2 0 1 7 ) e 1 4 5 ee 1 4 9
P2-151 Upper limb habilitation in children with hemiplegic cerebral palsy using a novel paediatric robotic device e Results from a Pilot Study H.T. Ong, C.L. Teo, J. Lin, J.X. Tan, M. Lee, E. Burdet, S.S. Ge. Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore Objective: Based on rehabilitation of adult stroke patients using robotic therapy, we explored a similar approach for upper limb (UL) habilitation of children with hemiplegic cerebral palsy (CP). Methods: We used a novel paediatric robotic device, reachMAN2, for the habilitation of UL in children age 4 to 16 years with hemiplegic CP. This device trained 3 important movements: pinching movement using thumb and index finger, forearm supination/pronation and wrist flexion/extension. An interactive virtual reality game was developed to engage the child for robotic therapy. Each child had 10 robotic therapy sessions over 4 weeks under the supervision of a research assistant. At each session, the child had robotic therapy lasting 15 minutes for each of the 3 movements, with a 2-minute break in between. Each child had 3 functional assessments performed by paediatric occupational therapists: first before robotic therapy (week 0); second within 2 weeks of completing robotic therapy (week 4e6); the third at 3 months after starting robotic therapy (week 12e14). The Body Function Level assessment included measurements of the range of movement (ROM) using a handheld goniometer, for the joints at the thumb and index finger, forearm supination and wrist extension. Activity Level was assessed using relevant subtests in the Bruininks-Oseretsky Test of Motor Proficiency 2nd Ed. (BOT-2). Results: We had 6 subjects, average age 7 year 10 months. At 3 months, the ROM at the metacarpo-phalangeal joints of the thumb and index finger, and forearm supination, had increased above 10% from the baseline. There was also improvement in the age equivalence achieved for the subtests of fine motor precision, fine motor integration and manual dexterity in the BOT-2, which ranged from 4 to 12 months. Conclusion: This pilot study established the feasibility of robotic habilitation for children with hemiplegic CP with some UL functional benefits achieved.
http://dx.doi.org/10.1016/j.ejpn.2017.04.1297 P2-152 Evaluating the efficacy of two types of AFOs on gait characteristics in children with CP Farzad Farmani, Seyyed-Davoud Mohammadi, Farshid Farmani. Department of Orthotics & Prosthetics, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran Objective: Children with Cerebral Palsy (CP) usually suffer from poor balance and decreased walking ability. Different Ankle Foot Orthoses (AFOs) are usually prescribed for them to improve their lost balance and walking ability. The aim of this study was to evaluate the efficacy of two types of AFOs on gait characteristics in children with CP. Methods: 16-hemiplegic children (12 boys and 4 girls) secondary to CP aged 6 to 13 participated in this study. The immediate effect of Solid AFO (SAFO) and Posterior Leaf Spring AFO (PLS AFO) was examined on gait characteristics using two force platforms and 10-m walk test in participants. Outcome measures were gait speed, step length, step width and cadence. The tests were performed in random sequences. Results: Both AFOs resulted in significantly faster gait speed and more step length, step width and cadence compared to no-AFO condition (P < 0.05). Also, no
significant difference was seen in step width and step length between two AFOs (P > 0.05). However, PLS AFO resulted in significantly faster gait speed and more cadence compared with SAFO (P < 0.05). Conclusion: Although both AFOs led to improved gait in children with CP, PLS AFO resulted in more improvement in gait abilities in the participants. It seems that saving and restoring energy through ankle part of the PLS AFO potentially contributes to more cadence and as a result faster gait speed in children with CP.
http://dx.doi.org/10.1016/j.ejpn.2017.04.1298 P2-153 Adequate transition of health care from child to adult for patients with motor disability: Environmental, medical and social challenges C. de Lattre, V. Gautheron, V. Tiffreau, A. Yelnick, C. Vuillerot. L'Escale PMR Department, University Hospital of Lyon, France Objective: Aging is a part of life that is inevitable for all of young patients with a motor disability. The time comes to leave pediatric teams for the adult's word, and it doesn't get without some fears and brakes from both sides. A group from the SOFMER (French society for Physical and Rehabilitation medicine) proposed a set of recommendations for good practices for the transition of health care from child to adult for patients with motor disability. Many domains were relevant: medical care but even training, independent living, education, employment and social/community life. Methods: A 3-step study was performed including i) a revue of the existing literature, ii) a public conference to include the professional participants remarks and comments following the literature review, iii) an approach by committee to review and valid the proposed recommendations. Results: The first step took place from February to October 2010. The recommendations, which emerged from this review and analysis, were discussed at the Marseille public conference on October 13th 2010 and further enhanced by the professional attendees practices and experiences. A multidisciplinary group reviewed these recommendations before a final submission to HAS (French High Health Authority) labelling. Conclusion: This stage requires anticipation and preparation. It must be started by child-centered health care sector in close relation with the adult medical team. The young (and his/her family) remains central to the process which will take some years. Two major periods were identified: the transition period and the transfer period. Some specific recommendations were developed according to epidemiology of motor disabilities, medical and administrative criteria, legal issues, emotional and psychological factors.
http://dx.doi.org/10.1016/j.ejpn.2017.04.1299 P2-154 Diffusion tensor tractography in children with developmental language delay Joo Hyun Park M.D. Ph.D., Ah-Ra Cho M.D, Hyun-Mi Oh M.D.. Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Collegel of Medicine, Seoul, South Korea Objective: Diffusion tensor tractography (DTT) is valuable for confirming the connectivity between functional cortical regions by a noninvasive method. This object is to evaluate language pathway in Korean speaking children for delayed language development by means of DTT. Methods: Patients were identified retrospectively with the chief complaint of delayed speech and diagnosis of developmental language delay established by
e u r o p e a n j o u r n a l o f p a e d i a t r i c n e u r o l o g y 2 1 ( 2 0 1 7 ) e 1 4 5 ee 1 4 9
P2-151 Upper limb habilitation in children with hemiplegic cerebral palsy using a novel paediatric robotic device e Results from a Pilot Study H.T. Ong, C.L. Teo, J. Lin, J.X. Tan, M. Lee, E. Burdet, S.S. Ge. Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore Objective: Based on rehabilitation of adult stroke patients using robotic therapy, we explored a similar approach for upper limb (UL) habilitation of children with hemiplegic cerebral palsy (CP). Methods: We used a novel paediatric robotic device, reachMAN2, for the habilitation of UL in children age 4 to 16 years with hemiplegic CP. This device trained 3 important movements: pinching movement using thumb and index finger, forearm supination/pronation and wrist flexion/extension. An interactive virtual reality game was developed to engage the child for robotic therapy. Each child had 10 robotic therapy sessions over 4 weeks under the supervision of a research assistant. At each session, the child had robotic therapy lasting 15 minutes for each of the 3 movements, with a 2-minute break in between. Each child had 3 functional assessments performed by paediatric occupational therapists: first before robotic therapy (week 0); second within 2 weeks of completing robotic therapy (week 4e6); the third at 3 months after starting robotic therapy (week 12e14). The Body Function Level assessment included measurements of the range of movement (ROM) using a handheld goniometer, for the joints at the thumb and index finger, forearm supination and wrist extension. Activity Level was assessed using relevant subtests in the Bruininks-Oseretsky Test of Motor Proficiency 2nd Ed. (BOT-2). Results: We had 6 subjects, average age 7 year 10 months. At 3 months, the ROM at the metacarpo-phalangeal joints of the thumb and index finger, and forearm supination, had increased above 10% from the baseline. There was also improvement in the age equivalence achieved for the subtests of fine motor precision, fine motor integration and manual dexterity in the BOT-2, which ranged from 4 to 12 months. Conclusion: This pilot study established the feasibility of robotic habilitation for children with hemiplegic CP with some UL functional benefits achieved.
http://dx.doi.org/10.1016/j.ejpn.2017.04.1297 P2-152 Evaluating the efficacy of two types of AFOs on gait characteristics in children with CP Farzad Farmani, Seyyed-Davoud Mohammadi, Farshid Farmani. Department of Orthotics & Prosthetics, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran Objective: Children with Cerebral Palsy (CP) usually suffer from poor balance and decreased walking ability. Different Ankle Foot Orthoses (AFOs) are usually prescribed for them to improve their lost balance and walking ability. The aim of this study was to evaluate the efficacy of two types of AFOs on gait characteristics in children with CP. Methods: 16-hemiplegic children (12 boys and 4 girls) secondary to CP aged 6 to 13 participated in this study. The immediate effect of Solid AFO (SAFO) and Posterior Leaf Spring AFO (PLS AFO) was examined on gait characteristics using two force platforms and 10-m walk test in participants. Outcome measures were gait speed, step length, step width and cadence. The tests were performed in random sequences. Results: Both AFOs resulted in significantly faster gait speed and more step length, step width and cadence compared to no-AFO condition (P < 0.05). Also, no
significant difference was seen in step width and step length between two AFOs (P > 0.05). However, PLS AFO resulted in significantly faster gait speed and more cadence compared with SAFO (P < 0.05). Conclusion: Although both AFOs led to improved gait in children with CP, PLS AFO resulted in more improvement in gait abilities in the participants. It seems that saving and restoring energy through ankle part of the PLS AFO potentially contributes to more cadence and as a result faster gait speed in children with CP.
http://dx.doi.org/10.1016/j.ejpn.2017.04.1298 P2-153 Adequate transition of health care from child to adult for patients with motor disability: Environmental, medical and social challenges C. de Lattre, V. Gautheron, V. Tiffreau, A. Yelnick, C. Vuillerot. L'Escale PMR Department, University Hospital of Lyon, France Objective: Aging is a part of life that is inevitable for all of young patients with a motor disability. The time comes to leave pediatric teams for the adult's word, and it doesn't get without some fears and brakes from both sides. A group from the SOFMER (French society for Physical and Rehabilitation medicine) proposed a set of recommendations for good practices for the transition of health care from child to adult for patients with motor disability. Many domains were relevant: medical care but even training, independent living, education, employment and social/community life. Methods: A 3-step study was performed including i) a revue of the existing literature, ii) a public conference to include the professional participants remarks and comments following the literature review, iii) an approach by committee to review and valid the proposed recommendations. Results: The first step took place from February to October 2010. The recommendations, which emerged from this review and analysis, were discussed at the Marseille public conference on October 13th 2010 and further enhanced by the professional attendees practices and experiences. A multidisciplinary group reviewed these recommendations before a final submission to HAS (French High Health Authority) labelling. Conclusion: This stage requires anticipation and preparation. It must be started by child-centered health care sector in close relation with the adult medical team. The young (and his/her family) remains central to the process which will take some years. Two major periods were identified: the transition period and the transfer period. Some specific recommendations were developed according to epidemiology of motor disabilities, medical and administrative criteria, legal issues, emotional and psychological factors.
http://dx.doi.org/10.1016/j.ejpn.2017.04.1299 P2-154 Diffusion tensor tractography in children with developmental language delay Joo Hyun Park M.D. Ph.D., Ah-Ra Cho M.D, Hyun-Mi Oh M.D.. Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Collegel of Medicine, Seoul, South Korea Objective: Diffusion tensor tractography (DTT) is valuable for confirming the connectivity between functional cortical regions by a noninvasive method. This object is to evaluate language pathway in Korean speaking children for delayed language development by means of DTT. Methods: Patients were identified retrospectively with the chief complaint of delayed speech and diagnosis of developmental language delay established by