Cerebral Palsy Gait and Orthotics Flashcards
What is drop foot?
The foot falls into equinous during swing, however dorsiflexion is seen during stance.
What is true equinous?
The ankle remains in plantarflexion throughout stance and swing.
What is apparent equinous?
The child may remain on their toes, however the ankle is plantargrade.
What is jump knee?
Increased knee flexion in early stance with normal knee extension later in stance. Hip has normal movement.
What is knee recurvatum?
The knee is in hyperextension during stance
What is stiff knee?
Decreased knee flexion during swing
What is crouch gait?
Increased hip and knee flexion with ankle dorsiflexion in stance
What is the main difference in presentation between spastic hemiplegia and diplegia?
Hemiplegia has more distal involvement, whereas dipegia has more proximal involvement
What are the five gait patterns of spastic hemiplegia?
I: Drop foot IIa: True equinous IIb: True equinous/knee recurvatum III: True equinous/jump knee IV: equinous/jump knee/hip IR, flex, adduction
What are the five gait patterns of spastic diplegia?
I: True equinous II: Jump gait III: Apparent equinous IV: Crouch gait V: Asymmetrical gait
What are the roles of orthotics in cerebral palsy management?
- Help prevent deformity and contractures
- Decrease impact of spasticity
- Reduce pain
- Correct gait pattern
- Improve balance
What are the three difference types of orthotics?
- Foot stabilising splint (FSS)
- Ankle foot orthotic (AFO): static or dynamic
- Ground reactive ankle foot orthotic (GRAFO)
When is a foot stabilising splint used? How long is it worn each day?
When excessive valgoid posture is present (calcaneal eversion and forefoot pronation). Worn in shoes for 6-8 each day.
What do static AFOs control?
Control triplanar aspects of foot position, by maintaining the ankle at 90 degrees.
What is required for a dynamic AFO to be effect?
Good hip and knee extension and adequate range in the gastrocnemius
