Efficiency of flexible derotator in walking cerebral palsy children

• Published in: Annals of physical and rehabilitation medicine 2011-09, Vol.54 (6), p.337-347
• Main Authors: Marcucci, A, Edouard, P, Loustalet, E, d’Anjou, M.-C, Gautheron, V, Degache, F
• Format: Article
• Language: English
• Subjects: Anthropometry; Appareillage; Biological and medical sciences; Biomechanical Phenomena; Bone torsion; Cerebral palsy; Cerebral Palsy - rehabilitation; Child; Diseases of the osteoarticular system; Diseases of the osteoarticular system. Orthopedic treatment; Dérotateur souple; Equipment Design; Femur - physiopathology; Flexible derotator; Gait; Gait Disorders, Neurologic - physiopathology; Gait Disorders, Neurologic - rehabilitation; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Internal Medicine; Marche; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Orthosis; Orthotic Devices; Paralysie cérébrale; Physical Medicine and Rehabilitation; Quality of Life; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Retrospective Studies; Tibia - physiopathology; Torsion osseuse; Torsion, Mechanical; Walking
• ISSN: 1877-0657; 1877-0665
• DOI: 10.1016/j.rehab.2011.07.960

Abstract Introduction The flexible derotator is one of the therapeutic resources used to combat primary and secondary abnormalities in walking cerebral palsy children. It was developed to reduce abnormal femoral and tibial torsions and lessen the latter's negative functional impact. Objective To determine the effect of wearing a flexible derotator on anatomic and functional parameters in walking cerebral palsy children. Methods We performed a retrospective study of walking cerebral palsy children by gathering data on bone-related parameters (femoral and tibial torsion) and functional parameters (distance and speed gait, and the energy expenditure index (EEI)). Fifteen walking cerebral palsy children were treated with the flexible derotator for one year and 15 untreated walking cerebral palsy children were included as controls. The two groups were compared in terms of the various parameters’ change over time between the initial examination (the last examination prior to the start of the study or prior to use of the flexible derotator) and the final examination (after one year of follow-up). Results Right femoral anteversion and right and left external tibial torsion improved. There was a significant increase in distance and speed gait and a decrease in the EEI in walking cerebral palsy children. Conclusion Our retrospective study revealed a significant improvement in functional parameters in children with cerebral palsy, as a result of wearing the flexible derotator for at least 6 hours a day for a year. Bone parameters only improved slightly. Use of the flexible derotator could improve these children's quality of life.