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12 pages, 288 KiB

Open AccessArticle

Walking Speed and Risk of Falling Patients Operated for Selected Malignant Tumors

by Anna Latajka, Małgorzata Stefańska, Marek Woźniewski and Iwona Malicka

Healthcare 2023, 11(23), 3069; https://doi.org/10.3390/healthcare11233069 - 30 Nov 2023

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Background: A literature review reveals that studies on walking and fall occurrences in the context of cancer have predominantly centered on geriatric patients. Nonetheless, cancer patients of all ages are susceptible to such risks. Both cancer and its treatments contribute to significant risk [...] Read more.

Background: A literature review reveals that studies on walking and fall occurrences in the context of cancer have predominantly centered on geriatric patients. Nonetheless, cancer patients of all ages are susceptible to such risks. Both cancer and its treatments contribute to significant risk factors for disturbances in walking and falls, encompassing muscle weakness, impaired balance, reduced proprioception, cognitive impairment, and functional limitations. Aim: to assess walking speed and the risk of falls among patients undergoing surgery for the most common malignancies: breast (BU), lung (P), colorectal (DS), and reproductive organs (G). Material and Methods: An observational study was conducted using a cohort design. A total of 176 individuals participated in the study, including 139 cancer patients, who were divided into four groups: BU (N = 30), P (N = 35), DS (N = 35), and G (N = 39), as well as 37 healthy volunteers in the control group (C, N = 37). All participants underwent an assessment of walking speed using BTS G-WALK^® and an evaluation of the number of falls and the risk of falling using a Fall Control Card. Results: There was a significant decrease in walking speed after surgery compared to the time before surgery, from 2.7% in the BU group, through 9.3% in the P group, and 19.2% in the DS group, to 30.0% in the G group. At the same time, for groups G and DS, the average walking speed fell below 1.0 m/s, amounting to 0.84 m/s and 0.97 m/s, respectively, in the measurement after the surgery and 0.95 m/s and 1.0 m/s in the follow-up measurement. Falling occurred in all the groups except for the BU group. The created logistic regression model showed that increasing the walking speed measured after the procedure (study 2) by 1 m/s reduces the risk of falling by approximately 500 times (OR = 0.002). Limitations in daily activity were observed in the follow-up examination (study 3) in 75% of patients. Conclusions: Surgical intervention has an impact on walking speed, and being part of the study group influences the risk of falling. Further research is needed to determine the precise risk of falls in cancer patients. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

12 pages, 1991 KiB

Open AccessArticle

Arabic Translation and Psychometric Validation of PROMIS General Life Satisfaction Short Form in the General Population

by Hadeel R. Bakhsh, Nouf S. Aldajani, Bodor Bin Sheeha, Monira I. Aldhahi, Atheer A. Alsomali, Ghada K. Alhamrani, Rahaf Z. Alamri and Rehab Alhasani

Healthcare 2023, 11(23), 3034; https://doi.org/10.3390/healthcare11233034 - 24 Nov 2023

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Abstract

This study aimed to translate the Patient-Reported Outcomes Measurement Information System (PROMIS) General Life Satisfaction Short Form (GLS SF5a) into the Arabic language and psychometrically validate the scale in the general population of Saudi Arabia. The translation processes followed the international recommendations of [...] Read more.

This study aimed to translate the Patient-Reported Outcomes Measurement Information System (PROMIS) General Life Satisfaction Short Form (GLS SF5a) into the Arabic language and psychometrically validate the scale in the general population of Saudi Arabia. The translation processes followed the international recommendations of the FACIT Measurement System. The study was a multicentre cross-sectional study conducted in Riyadh, Saudi Arabia. A total of 657 individuals who were above 18 years of age and able to write and comprehend Arabic completed the GLS SF5a. Rasch analysis was used to evaluate item fit, reliability indices, item difficulty, principal component analysis and local item dependency. WINSTEPS (v. 5.6.0) was used for the analysis. The translation process and cognitive defibring were completed with no issues. The rating scale categories had a disordered threshold. All items, except one, demonstrated a satisfactory fit to the Rasch model. The reliability of the person separation was 0.86. The scale was unidimensional, and no items showed local dependency. Overall, this study confirms the psychometric properties of the Arabic version of the PROMIS GLS SF5a, which can be used as an instrument for measuring general life satisfaction in the general population. Further research is required to explore responsiveness, interpretability and feasibility in the clinical setting. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

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16 pages, 930 KiB

Open AccessArticle

Complications of Intrathecal Baclofen Pump Therapy: An Institutional Experience from Saudi Arabia

by Ahmad Zaheer Qureshi, Hasan Shacfe, Amara Ilyas, Saeed Bin Ayaz, Khalid Yousef Aljamaan, Imad Saeed Moukais, Mohammed Jameel, Waqas Sami and Sami Ullah

Healthcare 2023, 11(21), 2820; https://doi.org/10.3390/healthcare11212820 - 25 Oct 2023

Viewed by 1104

Abstract

The intrathecal baclofen pump (ITB) is one of the advanced treatment options in the management of spasticity. This retrospective cohort study was conducted to identify the complications of ITB treatment at a tertiary care rehabilitation facility. Various demographic and technical factors were analyzed, [...] Read more.

The intrathecal baclofen pump (ITB) is one of the advanced treatment options in the management of spasticity. This retrospective cohort study was conducted to identify the complications of ITB treatment at a tertiary care rehabilitation facility. Various demographic and technical factors were analyzed, which are less often reported in the literature. All patients with ITB who had their refill at the ITB clinic between November 2019 and March 2020 were included. Of 48 patients, 17 patients had 18 (37.5%) ITB-related complications. Catheter-related complications were most common, whereas loss of efficacy (16.7%) and baclofen withdrawal (14.5%) were the most common outcomes of complications. Only catheter occlusion had a significant relationship with the pattern of spastic quadriparesis (p = 0.001). Gender, rehabilitation diagnosis, patients’ residence, and facility of ITB placement did not have significant association. Similarly, age, distance from hospital, disease onset, ITB therapy duration, and baclofen dose were not statistically significant in relation to ITB-related complications. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

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14 pages, 822 KiB

Open AccessArticle

Feasibility of a Home-Based Mirror Therapy Program in Children with Unilateral Spastic Cerebral Palsy

by Anna Ortega-Martínez, Rocío Palomo-Carrión, Carlos Varela-Ferro and Maria Caritat Bagur-Calafat

Healthcare 2023, 11(12), 1797; https://doi.org/10.3390/healthcare11121797 - 19 Jun 2023

Cited by 1 | Viewed by 1733

Abstract

Children with Unilateral Spastic Cerebral Palsy (US CP) have motor and somatosensory impairments that affect one side of their body, impacting upper limb functioning. These impairments contribute negatively to children’s bimanual performance and quality of life. Intensive home-based therapies have been developed and [...] Read more.

Children with Unilateral Spastic Cerebral Palsy (US CP) have motor and somatosensory impairments that affect one side of their body, impacting upper limb functioning. These impairments contribute negatively to children’s bimanual performance and quality of life. Intensive home-based therapies have been developed and have demonstrated their feasibility for children with US CP and their parents, especially when therapies are designed with the proper coaching of families. Mirror Therapy (MT) is being studied to become an approachable intensive and home-based therapy suitable for children with US CP. The aim of this study is to analyze the feasibility of a five-week home-based program of MT for children with US CP that includes coaching by the therapist. Six children aged 8–12 years old performed the therapy for five days per week, 30 min per day. A minimum of 80% of compliance was required. The feasibility included compliance evaluations, total dosage, perceived difficulty of the exercises, and losses of follow-ups. All children completed the therapy and were included in the analysis. The total accomplishment was 86.47 ± 7.67. The perceived difficulty of the exercises ranged from 2.37 to 4.51 out of 10. In conclusion, a home-based program of Mirror Therapy is a safe, cost-efficient, and feasible therapy for children with US CP when the therapist is involved as a coach during the entire program. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

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11 pages, 270 KiB

Open AccessArticle

The Masticatory Structure and Function in Children with Cerebral Palsy—A Pilot Study

by Karolina Szuflak, Roksana Malak, Brittany Fechner, Dorota Sikorska, Włodzimierz Samborski, Ewa Mojs and Karolina Gerreth

Healthcare 2023, 11(7), 1029; https://doi.org/10.3390/healthcare11071029 - 04 Apr 2023

Cited by 2 | Viewed by 1397

Abstract

(1) Background: Muscle tension around the head and neck influences orofacial functions. The data exist concerning head posture during increased salivation; however, little is known about muscle tightness during this process. This study aims to investigate whether or not any muscles are related [...] Read more.

(1) Background: Muscle tension around the head and neck influences orofacial functions. The data exist concerning head posture during increased salivation; however, little is known about muscle tightness during this process. This study aims to investigate whether or not any muscles are related to problems with eating, such as drooling in individuals with cerebral palsy; (2) Methods: Nineteen patients between the ages of 1 and 14 were examined prior to the physiotherapy intervention. This intervention lasted three months and consisted of: relaxing muscles via the strain-counterstrain technique, functional exercises based on the NeuroDevelopmental Treatment-Bobath method, and functional exercises for eating; (3) Results: the tone of rectus capitis posterior minor muscle on the left side (p = 0.027) and temporalis muscle on the right side (p = 0.048) before the therapy, and scalene muscle on the right side after the therapy (p = 0.024) were correlated with drooling behavior and were considered statistically significant. Gross motor function was not considered statistically significant with the occurrence of drooling behavior (p ≤ 0.05). Following the therapeutic intervention, the frequency of drooling during feeding decreased from 63.16% to 38.89% of the total sample of examined patients; (4) Conclusions: The tightness of the muscles in the head area can cause drooling during feeding. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

16 pages, 1380 KiB

Open AccessArticle

Effectiveness of Vestibular Rehabilitation after Concussion: A Systematic Review of Randomised Controlled Trial

by Erasmo Galeno, Edoardo Pullano, Firas Mourad, Giovanni Galeoto and Francesco Frontani

Healthcare 2023, 11(1), 90; https://doi.org/10.3390/healthcare11010090 - 28 Dec 2022

Cited by 5 | Viewed by 3045

Abstract

Introduction: Mild traumatic brain injury (mTBI) affects approximately 740 cases per 100,000 people. Impairments related to mTBI include vertigo, dizziness, balance, gait disorders double or blurry vision, and others. The efficacy on acute or chronic phase and dosage of vestibular rehabilitation (VR) in [...] Read more.

Introduction: Mild traumatic brain injury (mTBI) affects approximately 740 cases per 100,000 people. Impairments related to mTBI include vertigo, dizziness, balance, gait disorders double or blurry vision, and others. The efficacy on acute or chronic phase and dosage of vestibular rehabilitation (VR) in reducing these symptoms is not clearly stated. To clarify these points, we performed a systematic review of randomised controlled trials (RCTs). Methods: A systematic literature search was performed from 2015 to 2022 on PubMed, CINAHL, Cochrane Trial SPORTDiscus, Web of Science, and PEDRO. Eligibility criteria were RCTs which consider VR, participants with mTBI, and no gender or age restriction. Two blinded reviewers independently selected the study, and a third author was contacted in case of disagreements. Risk of bias was independently screened by two authors and successively checked by the other two authors. Results: Thirty-three full articles were read for potential inclusion and seven records met the inclusion criteria. The authors analysed different outcomes considering DHI, a meta-analysis was carried out, statistical difference was observed (p < 0.01), and a mean difference of −6.91 (−9.11, −4.72) in favour of VR was shown. Considering quality of life, the VR group reached a higher score on QOLIBRI. Controversial results were shown about balance and subjective symptoms questionnaire. Differently considering HiMAT, the authors showed a statistically important difference in favour of VR (p = 0.002). Conclusion: VR seems useful to reduce symptoms in patients with concussion; however, a huge heterogeneity of the studies and of the outcomes used were found. Therefore, a larger sample is necessary to assess the efficacy of VR. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

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10 pages, 619 KiB

Open AccessArticle

Ataxia Rating Scales: Content Analysis by Linking to the International Classification of Functioning, Disability and Health

by Mohammad Etoom, Alhadi M. Jahan, Alia Alghwiri, Francesco Lena and Nicola Modugno

Healthcare 2022, 10(12), 2459; https://doi.org/10.3390/healthcare10122459 - 05 Dec 2022

Viewed by 1795

Abstract

Ataxia management is mainly based on rehabilitation, symptomatic management, and functional improvement. Therefore, it is important to comprehensively assess ataxic symptoms and their impact on function. Recently, the movement disorders society recommended four generic ataxia rating scales: scale for assessment and rating of [...] Read more.

Ataxia management is mainly based on rehabilitation, symptomatic management, and functional improvement. Therefore, it is important to comprehensively assess ataxic symptoms and their impact on function. Recently, the movement disorders society recommended four generic ataxia rating scales: scale for assessment and rating of ataxia (SARA), international cooperative ataxia rating scales, Friedreich’s ataxia rating scale (FARS), and unified multiple system atrophy rating scale (UMSARS). The aim of the study was to analyze and compare the content of the recommended ataxia rating scales by linking them to the international classification of functioning, disability and health (ICF). A total of 125 meaningful concepts from 93 items of the four included scales were linked to 57 different ICF categories. The ICF categories were distributed in body structure (n = 8), body function (n = 26), activity and participation (n = 20), and environmental factors (n = 3) components. UMSARS and FARS were the only ones that have addressed the body structure or environmental factors component. The content analysis of ataxia rating scales would help clinicians and researchers select the most appropriate scale and understand ataxic symptoms and their impact on function. It seems that SARA is the optimal scale for rapid assessment of ataxia or in busy clinical settings. UMSARS or FARS are more appropriate for the investigating the impact of ataxia on overall health, and monitoring ataxia progression and disability. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

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15 pages, 5335 KiB

Open AccessArticle

Habilitation of Executive Functions in Pediatric Congenital Heart Disease Patients through LEGO^®-Based Therapy: A Quasi-Experimental Study

by Eduardo Espinosa-Garamendi, Norma Angélica Labra-Ruiz, Lizbeth Naranjo, Claudia Andrea Chávez-Mejía, Erika Valenzuela-Alarcón and Julieta Griselda Mendoza-Torreblanca

Healthcare 2022, 10(12), 2348; https://doi.org/10.3390/healthcare10122348 - 23 Nov 2022

Cited by 1 | Viewed by 1559

Abstract

Congenital heart disease is defined as an abnormality in the cardiocirculatory structure or function. Various studies have shown that patients with this condition may present cognitive deficits. To compensate for this, several therapeutic strategies have been developed, among them, the LEGO^® Education [...] Read more.

Congenital heart disease is defined as an abnormality in the cardiocirculatory structure or function. Various studies have shown that patients with this condition may present cognitive deficits. To compensate for this, several therapeutic strategies have been developed, among them, the LEGO^® Education sets, which use the pedagogic enginery to modify cognitive function by didactic material based on mechanics and robotics principles. Accordingly, the goal of this study was to evaluate the effect of cognitive habilitation by using LEGO^®-based therapy in pediatric congenital heart disease patients. This was a quasi-experimental study; eligible patients were identified, and their general data were obtained. In the treatment group, an initial evaluation with the neuropsychological BANFE-2 test was applied; then, once a week, the interventions were performed, with a final test at the end of the interventions. In the control group, after the initial evaluation, a second appointment was scheduled for the final evaluation. Our results show that >50% of children presented cognitive impairment; nevertheless, there was an overall improvement in treatment patients, showing a significant increase in BANFE scores in areas related to executive functions. LEGO^®-based therapy may be useful to improve cognitive abilities; however, future research should be performed to strengthen the data. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

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10 pages, 962 KiB

Open AccessArticle

Manual Physiotherapy Combined with Pelvic Floor Training in Women Suffering from Stress Urinary Incontinence and Chronic Nonspecific Low Back Pain: A Preliminary Study

by Gianluca Giordani, Sara De Angelis, Annunziata Isabella Parisi, Andrea Cosimo D’amico, Moira Di Re, Chiara Liumbruno, Federica Tamburella, Danilo Lisi, Giovanni Galeoto and Marco Tramontano

Healthcare 2022, 10(10), 2031; https://doi.org/10.3390/healthcare10102031 - 14 Oct 2022

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Abstract

Stress urinary incontinence (SUI) represents one of the most common subtypes of urinary incontinence (UI) reported by women. Studies have shown an association of SUI with nonspecific low back pain (NSLBP). The primary aim of the present study was to explore the long-term [...] Read more.

Stress urinary incontinence (SUI) represents one of the most common subtypes of urinary incontinence (UI) reported by women. Studies have shown an association of SUI with nonspecific low back pain (NSLBP). The primary aim of the present study was to explore the long-term effects of a combined treatment of manual techniques and pelvic floor muscle (PFM) training in women suffering from SUI associated with NSLBP. The secondary aim was to evaluate which manual approach combined with PFM rehabilitation is more effective in improving symptoms related to SUI and in reducing pain perception related to NSLBP. Twenty-six patients suffering from SUI associated with chronic NSLBP were randomly assigned to one of two groups: the postural rehabilitation group (PRg) or the spinal mobilization group (SMg). Both groups performed a manual approach combined with PFM rehabilitation. All patients were evaluated before the treatment (T0), after 10 sessions (T1) and after 30 days from the end of the treatment (T2). The results showed an improvement in both groups in all of the investigated outcomes. Combining manual therapy and PFM training within the same therapy session may be useful for improving both SUI and NSLBP and increasing the quality of life of women suffering from SUI associated with NSLBP. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

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8 pages, 892 KiB

Open AccessArticle

Clinical Items for Geriatric Patients with Post-Stroke at Discharge or Transfer after Rehabilitation Therapy in a Chronic-Phase Hospital: A Retrospective Pilot Study

by Masatoshi Koumo, Akio Goda, Yoshinori Maki, Kouta Yokoyama, Tetsuya Yamamoto, Tsumugi Hosokawa, Ryota Ishibashi, Junichi Katsura and Ken Yanagibashi

Healthcare 2022, 10(8), 1577; https://doi.org/10.3390/healthcare10081577 - 19 Aug 2022

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Abstract

Clinical factors related to destination after rehabilitation therapy for geriatric patients with post-stroke in chronic-phase hospitals have not been elucidated. This study analyzed the clinical characteristics of geriatric patients with post-stroke at discharge/transfer after rehabilitation therapy in a chronic-phase hospital. Fifty-three patients (20 [...] Read more.

Clinical factors related to destination after rehabilitation therapy for geriatric patients with post-stroke in chronic-phase hospitals have not been elucidated. This study analyzed the clinical characteristics of geriatric patients with post-stroke at discharge/transfer after rehabilitation therapy in a chronic-phase hospital. Fifty-three patients (20 men, 33 women; mean age 81.36 ± 8.14 years) were recruited (the period analyzed: October 2013–March 2020). Clinical data were statistically analyzed among patients discharged to homes or facilities for older adults or transferred to another hospital. In addition, we analyzed the clinical items at discharge and transfer after rehabilitation therapy using a decision tree analysis. Twelve patients were discharged, eighteen were discharged to facilities for older adults, and twenty-three were transferred to another hospital. There were significant differences in the modified Rankin Scale, admission dates, functional independence measure (FIM) score, and Barthel Index score in the three groups (p < 0.05). Patients with motor subtotal functional independence scores of ≥14 (chronologically improved ≥5) after rehabilitation therapy for <291 days were more likely to be discharged home. Patients in a chronic-phase hospital who improved within a limited period were discharged to their homes, whereas those who were bedridden tended to be transferred to another hospital. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

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19 pages, 4699 KiB

Open AccessTechnical Note

Sexual Disability in Low Back Pain: Diagnostic and Therapeutic Framework for Physical Therapists

by Carla Vanti, Silvano Ferrari, Marco Chiodini, Cesare Olivoni, Arianna Bortolami and Paolo Pillastrini

Healthcare 2024, 12(1), 80; https://doi.org/10.3390/healthcare12010080 - 29 Dec 2023

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Abstract

Background: The literature shows a relationship between sexual activity and low back pain (LBP). The aim of this work is to provide a theoretical framework and practical proposal for the management of sexual disability in individuals with LBP. Methods: Based on a literature [...] Read more.

Background: The literature shows a relationship between sexual activity and low back pain (LBP). The aim of this work is to provide a theoretical framework and practical proposal for the management of sexual disability in individuals with LBP. Methods: Based on a literature review, a team of specialized physical therapists developed a pattern for the management of LBP-related sexual disability. Results: A patient reporting LBP-related sexual disability may be included in one of four clinical decision-making pathways corresponding to one of the following: #1 standard physical therapy (PT); #2 psychologically informed physical therapy (PIPT); #3 PIPT with referral; or #4 immediate referral. Standard PT concerns the management of LBP-related sexual disability in the absence of psychosocial or pathological issues. It includes strategies for pain modulation, stiffness management, motor control, stabilization, functional training, pacing activities comprising education, and stay-active advice. PIPT refers to patients with yellow flags or concerns about their relationship with partners; this treatment is oriented towards a specific psychological approach. “PIPT with referral” and “Immediate referral” pathways concern patients needing to be referred to specialists in other fields due to relationship problems or conditions requiring medical management or pelvic floor or sexual rehabilitation. Conclusions: The proposed framework can help clinicians properly manage patients with LBP-related sexual disability. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

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22 pages, 643 KiB

Open AccessSystematic Review

Effectiveness of Respiratory Rehabilitation in COVID-19’s Post-Acute Phase: A Systematic Review

by Matteo Tamburlani, Rossana Cuscito, Annamaria Servadio and Giovanni Galeoto

Healthcare 2023, 11(8), 1071; https://doi.org/10.3390/healthcare11081071 - 08 Apr 2023

Cited by 10 | Viewed by 2331

Abstract

Background: The COVID-19 pandemic, caused by the new grave and acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), generated an unprecedented danger to public health. This condition may impact survivors’ quality of life and includes extensive pulmonary and respiratory outcomes. Respiratory rehabilitation is known for its [...] Read more.

Background: The COVID-19 pandemic, caused by the new grave and acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), generated an unprecedented danger to public health. This condition may impact survivors’ quality of life and includes extensive pulmonary and respiratory outcomes. Respiratory rehabilitation is known for its effects in improving dyspnea, alleviating anxiety and depression, reducing complications, preventing and ameliorating dysfunctions, reducing morbidity, preserving functions and improving subjects’ quality of life. For this reason, respiratory rehabilitation may be recommended for this category of patients. Objective: Our objective was to evaluate the effectiveness and benefits produced by the adoption of pulmonary rehabilitation (PR) programs in COVID-19’s post-acute phase. Material and Methods: A search of relevant publications was conducted using the following electronic databases: PubMed, Scopus, PEDro, and Cochrane Library. A single reviser selected pertinent articles that studied the effects of pulmonary rehabilitation during COVID-19’s post-acute phase in improving the respiratory function, physical performance, autonomy and quality of life (QoL). Results: After an initial selection, 18 studies were included in this systematic review, of which 14 concern respiratory rehabilitation delivered in conventional form and 4 concern respiratory rehabilitation provided in telehealth. Conclusions: Pulmonary rehabilitation combining different types of training—breathing, aerobic, fitness and strength—and not bypassing the neuropsychological aspects revealed itself to be capable of improving pulmonary and muscular functions, general health and quality of life in post-acute COVID-19 patients, besides increasing workout capacity and muscle strength, improving fatigue states and reducing anxiety and depression. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

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10 pages, 2294 KiB

Open AccessBrief Report

Ankle Kinematics Characterization in Children with Idiopathic Toe Walking: Does the Foot Model Change the Clinical Evaluation?

by Paolo Brasiliano, Martina Alvini, Eugenio Di Stanislao, Giuseppe Vannozzi, Giuseppe Di Rosa and Valentina Camomilla

Healthcare 2023, 11(6), 873; https://doi.org/10.3390/healthcare11060873 - 16 Mar 2023

Viewed by 1320

Abstract

Idiopathic toe walking (ITW) is a gait deviation characterized by forefoot contact with the ground, sometimes observed in children, that alters ankle kinematics, possibly leading to health-related issues. When studying foot and ankle gait deviations, the adoption of a single-segment foot model entails [...] Read more.

Idiopathic toe walking (ITW) is a gait deviation characterized by forefoot contact with the ground, sometimes observed in children, that alters ankle kinematics, possibly leading to health-related issues. When studying foot and ankle gait deviations, the adoption of a single-segment foot model entails a significant simplification of foot and ankle movement, and thus may potentially mask some important foot dynamics. Differences in ankle kinematics between single- (conventional gait model, PiG, or Davis) and multi-segment (Oxford foot model, OFM) foot models were investigated in children with ITW. Fourteen participants were enrolled in the study and underwent instrumented gait analysis. Children were asked to walk barefoot and while wearing a foot orthosis that modified the ankle movement pattern toward a more physiological one without blocking foot intrinsic motion. ITW gait abnormalities, e.g., the absence of heel rocker and the presence of anticipated forefoot rocker, were found/not found according to the foot model. Walking conditions significantly interacted with the foot model effect. Finally, the different characterization of gait abnormalities led to a different classification of ITW, with a possible impact on the clinical evaluation. Due to its closer adhesion to ankle anatomy and to its sensitivity to ITW peculiarities, OFM may be preferable for instrumented gait analysis in this population. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

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