The effect of ankle-foot orthosis on gait and the procedures used to assess bi-articular muscle length and spasticity in subjects with diplegic cerebral palsy

Ankle-foot orthoses are commonly prescribed amongst subjects with diplegic cerebral palsy as a conservative orthotic intervention. Multi-articular and bi-articular muscles are more severely involved in subjects with diplegic cerebral palsy. Appropriate clinical assessment including assessment of these muscles enables optimum ankle-foot orthosis footwear combination (AFO-FC) prescription and any required adjunct therapy.The overarching aim of this thesis was to investigate the effect of optimisation of the temporal midstance shank kinematics with the use of an AFO- FC on several variables including shank kinematics, thigh kinematics, vertical component of ground reaction force (FZ2) and ground reaction force (GRF) alignment in relation to hip and knee joint in temporal midstance to late stance. The understanding of the implication of, and the tools used to conduct assessment procedures and measurement processes were tested in the assessment of bi-articular muscles (specifically rectus femoris), to ascertain if results were predictive of presenting gait deviations and hence provide information to optimise treatment.The results of initial study suggested that a positive influence on the shank kinematics, thigh kinematics, FZ2 and GRF alignment in relation to hip and knee joint in temporal midstance to late stance was observed with the use of an AFO-FC. The results of a further study illustrated that a dominance relationship of the catch angle/length of rectus femoris (RF) measured using the Duncan-Ely with the knee or the hip joints varies at different gait points/periods. Additionally, the effect of dynamic shortness of4the RF differed on gait from the effect of true shortness. The results of series of studies testing the feasibility of using a 2-dimensional analysis system (PnO Clinical Movement Data) for hip, knee and ankle sagittal plane passive joint range of motion measurement during physical assessment confirmed the reliability and accuracy of this system.

Name dc:type.qualificationname

phd

Level dc:type.qualificationlevel

doctoral-pg

Grantor dc:publisher.institution

University of Strathclyde

Year dc:date.issued

2018

Author dc:creator

• Mohsin, Fatma

Advisors dc:contributor.advisor

• Bowers, Roy
• McGarry, Anthony

DOI

10.48730/8b0m-b793

Identifier

T14840

Author Identifier

201190468

OAI identifier oai:identifier

oai:strathclyde:w3763682w