Dynamic splinting home therapy for toe walking: a case report

Cases Journal - 2009
Pamela Lundequam1, F Buck Willis2,3
1Methodist Hospital, St. Louis Park, USA
2University of Phoenix, Axia College, Phoenix, USA
3Dynasplint Systems, Clinical Research, Severna Park, USA

Tóm tắt

Serial casting is frequently prescribed for toe-walking but that does not allow continued physical therapy (PT). This report described a child and family who chose dynamic splinting (DS) with concurrent PT for treatment. The patient presented with right hemiparesis; below average motor skills and a gait pattern of toe contact (without ankle foot orthosis). Four months of PT plus 6 hours/night of DS as home therapy, the patient's passive dorsiflexion increased 14° and she gained the ability to walk in "flat foot" contact without the Ankle Foot Orthosis. This concurrent treatment achieved improved gait pattern and strength training not possible with casting.

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Tài liệu tham khảo

Booth MY, Yates CC, Edgar TS, Bandy WD: Serial casting vs. combined intervention with botulinum toxin A and serial casting in the treatment of spastic equinus in children. Pediatr Phys Ther. 2003, 15 (4): 216-220. 10.1097/01.PEP.0000096382.65499.E2.

Armand S, Watelain E, Mercier M, Lensel G, Lepoutre FX: Identification and classification of toe-walkers based on ankle kinematics, using a data-mining method. Gait Posture. 2006, 23 (2): 240-248. 10.1016/j.gaitpost.2005.02.007.

Romkes J, Hell AK, Brunner R: Changes in muscle activity in children with hemiplegic cerebral palsy while walking with and without ankle-foot orthoses. Gait Posture. 2006, 24 (4): 467-474. 10.1016/j.gaitpost.2005.12.001.

Brouwer B, Davidson LK, Olney SJ: Serial casting in idiopathic toe-walkers and children with spastic cerebral palsy. J Pediatr Orthop. 2000, 20 (2): 221-225. 10.1097/00004694-200003000-00017.

Romkes J, Brunner R: Comparison of a dynamic and a hinged ankle-foot orthosis by gait analysis in patients with hemiplegic cerebral palsy. Gait Posture. 2002, 15 (1): 18-24. 10.1016/S0966-6362(01)00178-3.

Galli M, Crivellini M, Santambrogio GC, Fazzi E, Motta F: Short-term effects of "botulinum toxin a" as treatment for children with cerebral palsy: kinematic and kinetic aspects at the ankle joint. Funct Neurol. 2001, 16 (4): 317-323.

Hemo Y, Macdessi SJ, Pierce RA, Aiona MD, Sussman MD: Outcome of patients after Achilles tendon lengthening for treatment of idiopathic toe walking. J Pediatr Orthop. 2006, 26 (3): 336-340.

Weigl D, Copeliovitch L, Itzchak Y, Strauss S: Sonographic healing stages of Achilles tendon after tenomuscular lengthening in children with cerebral palsy. J Pediatr Orthop. 2001, 21 (6): 778-783. 10.1097/00004694-200111000-00015.

Lai J, Jones M, Willis B: Efficacy of Dynasplint Splinting on Tone and Contracture Seen in CVA and TBI Patients: A Controlled Cross-Over Study. Arch Phys Med Rehabil. 2007, 88 (10): E-7-10.1016/j.apmr.2007.08.040.

Finger E, Willis FB: Dynamic splinting for knee flexion contracture following total knee arthroplasty: a case report. Cases Journal. 2008, 1: 421-10.1186/1757-1626-1-421.

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