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Orthotics Breakthrough Helps Improve Overall Mobility for People with CP

Richard_ScopeRichard_Scope Posts: 2,733

Scope community team

Researchers have confirmed that adapting splints in combination with the footwear used by disabled children to help them walk can decrease the energy they use by as much as 33%.

The Clinical Biomechanics team at Staffordshire University and the orthotics specialists from The Royal Wolverhampton NHS Trust examined the effectiveness of tuning the splint – footwear combination, using clinical trials with families in the West Midlands.

Nachi Chockalingam, Professor of Clinical Biomechanics, explained: "Helping children with disabilities to play longer and do the things that other children can do is important for all families. The more children with disabilities can play with their friends and do activities they enjoy, the more included they feel.

"We know that children with cerebral palsy use more energy to walk and our team have found fine-tuning splints to suit the individual needs of a child can make a huge difference to their overall mobility."

Our research shows that the appropriate design and tailoring of splints can reduce the energy used by children with CP while increasing their speed and distance, compared with a splint which is not fine-tuned. This is something which could have a significant impact on their quality of life."

Dr. Nicola Eddison, Clinical lead for Orthotics Service at The Royal Wolverhampton NHS Trust and a Senior Research Fellow, Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University

During the study, the researchers analysed the walking pattern of children with cerebral palsy at Staffordshire University's specialist gait laboratory and participants were assessed while barefoot and with both non-tuned and tuned splints.

Children wearing the fine-tuned splints showed improvements in several areas including hip and pelvic function and knee extension, while a non-tuned splint potentially showed a decrease in hip function.

Mrs Susan Hayfield, from Wolverhampton, is the mother of 15-year-old Robert who lives with Cerebral Palsy. She said: "Dr Eddison and her team have helped Robert from the age of three with his mobility.

"After having his footwear and splint adapted, my son's walking improved. This treatment has enabled him to be active for longer and he has felt less fatigued, which have all helped to give him a better quality of life"

Robert added: "Wearing the splint helps me stay off my toes and to help me walk heel to toe instead of toe to heel. The splint keeps my foot at a 90-degree angle which supports my walking. When I first remember wearing a splint, I felt different from other people, but now I just feel like it's normal for me."

The researchers recommend fine-tuning splints for all children with cerebral palsy who wear them and hope that their findings will be used to inform future clinical practice. Both Dr Eddison and Professor Chockalingam are calling for standardisation of terminologies used within splints, which are also known as Ankle Foot Orthoses (AFO), to help future research and clinical practice.

Professor Chockalingam added: "There still remains a lack of research on the longer-term effects of using a fine-tuned splints but our studies provide a stepping stone to improving quality of life for many children."

Scope
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Replies

  • janer1967janer1967 Member Posts: 9,265 Disability Gamechanger
    Thanks for sharing 
  • StayceStayce Member Posts: 398 Pioneering
    Hi @Richard_Scope

    Hope all is well with you.

    This is a most interesting post👍. I’ve always found fine tuning orthotics has been necessary for any of my orthotics to be successful. The key for me has always been finding an orthotist who is prepared to do this fine tuning

    I wonder if this study will expand to adults
  • Richard_ScopeRichard_Scope Posts: 2,733

    Scope community team

    Hi @Stayce, I am really hoping it does, the study has shown really positive results so far. So, I can't see a valid reason not to extend it to adults.
    How are things with you? 
    Scope
    Specialist Information Officer - Cerebral Palsy

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  • StayceStayce Member Posts: 398 Pioneering
    Hi @Richard_Scope

    I’m doing okay. I’ve been in a lot of pain as a consequence of lockdown and no access to therapy (my home physio programme only got me to about week 8 😀)

    Things have starting to open up a bit now though. So was able to see osteopath last week which helped immensely as my ankle was at risk of permanent contracture!

    I’ve also got an orthotic appointment next week for an AFO casting which would have been massively useful if I’d managed to get in for this before lockdown as it was an AFO to use at home (the irony)
    - So looking forward to getting that sorted

    How have things been with you?


  • Richard_ScopeRichard_Scope Posts: 2,733

    Scope community team

    So glad the osteopath was able to help you. Things have been pretty similar to you, much more pain in my knees, particularly the right one. My exercise regime is limited and the gym has been closed for such a long time! 
    I have tried my hand at Adaptive Yoga. It's something way out of my comfort zone but I enjoyed it! Have you found that the lockdown has made getting appointments for orthotics easier or not? 
    Scope
    Specialist Information Officer - Cerebral Palsy

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  • StayceStayce Member Posts: 398 Pioneering
    Hi @Richard_Scope
    I’m sorry to hear you have been in more pain during lockdown Adaptive yoga sounds interesting. I’ll check it out (it would be outside my comfort zone too 😀)

    I don’t know about you but I’ve been trying every muscle rub under the sun😀 and CBD oil (to no avail)

    It does seem that as things open up slowly it is much easier to get appointments. I could have gone earlier than next week for my orthotic appointment, but am working

    Take care 


  • Richard_ScopeRichard_Scope Posts: 2,733

    Scope community team

    I have been willing to try almost anything, yoga included! I have never had any beneficial effects of CBD oil. I know plenty have though. I have tried all of the rubs and the only one that seems to help (slightly) is Tiger Balm.
    I have been considering going for botox. I've never had it before but like I said willing to try almost anything.
    Scope
    Specialist Information Officer - Cerebral Palsy

    Want to tell us about your experience on the community? Talk to our chatbot and let us know. 
  • StayceStayce Member Posts: 398 Pioneering
    edited June 2020
    Hi @Richard_Scope
    I’m yet to find a CBD oil that works for me either. It’s as if it doesn’t even touch the sides 😀. You know when you really want something to work...

    The one I prefer is pureessentiel articulations and muscles in a roller format ( think it’s french) But there are some very strong warnings on it particularly around epilepsy etc. So please anyone reading that please look at those warnings on the product first as it won’t suit everyone and it’s not suitable for children

    I went through a long phase of I’ll never have Botox ( due to risks) . Then the pain got so bad I changed my mind and went for an assessment about two years ago (so I know where you are coming from) But at assessment it revealed that I used my tight muscles as a substitute for strength and they thought Botox would make my muscle too weak to function. So that was that. I was assessed for EMS (to wear all day) as well, but that was a no go too. My muscles didn’t respond how they wanted them to due to dystonia

    Have you ever tried a TENs machine? Or Lycra splints I’ve found these can decrease pain and lower tone

    Best wishes
  • Richard_ScopeRichard_Scope Posts: 2,733

    Scope community team

    I'm pretty much wheelchair based now so I might be okay for the botox. I haven't used a TENS machine (yet).
    Scope
    Specialist Information Officer - Cerebral Palsy

    Want to tell us about your experience on the community? Talk to our chatbot and let us know. 
  • StayceStayce Member Posts: 398 Pioneering
    Yes certainly worth being assessed for Botox - see what they say, then you can make a decision from there.

    TENs machines worth a try. Physio taught me how to use one and how to place electrode pads. I’m sure they could talk you through it via virtual consultation, if you wanted to try it.

    take care
  • Richard_ScopeRichard_Scope Posts: 2,733

    Scope community team

    Thanks, @Stayce.
    Scope
    Specialist Information Officer - Cerebral Palsy

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