Browsing by Author "Cordovil, Rita"
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- Efficacy of suit therapy on functioning in children and adolescents with cerebral palsy: a systematic review and meta-analysisPublication . Martins, Maria Elisabete; Cordovil, Rita; Oliveira, Raul; Letras, Sara; Lourenço, Soraia; Pereira, Inês; Ferro, Ana; Lopes, Inês; Silva, Cláudia; Marques, MartaAim: This systematic review and meta-analysis presents an overview of the efficacy of suit therapy on functioning in children and adolescents with cerebral palsy (CP). Method: A systematic review with meta-analysis was conducted. A comprehensive search of peer-reviewed articles was performed on electronic databases, from their inception to May 2014. Studies included were rated for methodological quality using the Physiotherapy Evidence Database scale. Effects of suit therapy on functioning were assessed using meta-analytic techniques. Results: From the 46 identified studies, four met the inclusion criteria and were included in the meta-analysis. Small, pooled effect sizes were found for gross motor function at post-treatment (g=0.46, 95% confidence interval [CI] 0.10-0.82) and follow-up (g=0.47, 95% CI 0.03-0.90). Interpretation: The small number of studies, the variability between them, and the low sample sizes are limitations of this review. Findings suggest that to weigh and balance benefits against harms, clinicians, patients, and families need better evidence to examine and prove the effects of short intensive treatment such as suit therapy on gross motor function in children and adolescents with CP. Therefore, more research based on high-quality studies focusing on functioning in all dimensions of the International Classification of Functioning, Disability and Health perspective is necessary to clarify the impact of suit therapy.
- The immediate effects of a dynamic orthosis on gait patterns in children with unilateral spastic cerebral palsy: a kinematic analysisPublication . Martins, Maria Elisabete; Cordovil, Rita; Oliveira, Raúl; Pinho, Joana; Diniz, Ana; Vaz, João RThis study analyzes the immediate effects of wearing a Therasuit on sagittal plane lower limb angular displacements during gait in children with unilateral spastic cerebral palsy (US-CP). Seven participants (median age = 7.00 years; ranging from 5.83 to 9.00 years) with US-CP, levels I and II of the Gross Motor Function Classification System, were assessed with kinematic gait analysis in three different conditions: (A) Baseline; (B) Therasuit without elastics and (C) Therasuit with elastics. Significant improvements were observed at the hip joint of both lower limbs during most of the gait cycle in participants wearing a Therasuit, including a decrease in the flexion pattern at the initial contact and swing phase in both lower limbs, and an increase in the extension pattern in the paretic lower limb during the stance phase. At the knee joint in the paretic lower limb, significant differences were found between the baseline and Therasuit with elastics conditions on the knee angle at initial contact, and between baseline and both Therasuit conditions on the flexion angle at swing phase. However, the inter-individual variability in kinematic patterns at the knee joint was high. At the ankle joint, decreased plantar flexion at initial contact and increased dorsiflexion during stance and swing phases were observed at the Therasuit with elastics condition, helping to correct the equinus-foot in the paretic lower limb during the whole gait cycle. The Z-values showed large effect sizes particularly for most of the angular hip variables in both lower limbs and for the angular ankle variables in the paretic lower limb. The Therasuit seems to have some positive immediate effects on gait kinematics in children with spastic unilateral cerebral palsy by providing a more functional and safer gait pattern. Future investigations with larger samples are recommended to further support these findings.
- The immediate effects of Therasuit® on the gait pattern of a child with unilateral spastic cerebral palsyPublication . Martins, Maria Elisabete; Cordovil, Rita; Oliveira, Raúl; Pinho, Joana; Vaz, João RAims: This study analyzes the immediate effects of using TheraSuit® (TS) on the gait of a child with left spastic hemiplegia level II (GMFCS). Methods: Spatiotemporal gait parameters and kinematic variables in the sagittal plane were compared between baseline and TS conditions. Results: Positive effects were noted on temporal parameters in the TS condition, such as a reduced gait cadence. The analysis of angular displacements in joint angles showed that at initial contact there was a reduction in the: (i) Plantarflexion on the paretic side; (ii) Dorsiflexion on the non-paretic side; and (iii) Knee flexion angles in both limbs. Furthermore, an increase in hip and knee extension angles during stance, and a decrease in knee and hip flexion on the non-paretic limb during swing were also detected. Conclusions: Further investigations with larger samples are necessary to confirm these effects of wearing TS on gait kinematics, aiming toward providing a more functional and safer gait pattern in children with spastic hemiplegia.
- The use of a dynamic orthosis in a child with unilateral spastic Cerebral Palsy: effects on gait kinematicsPublication . Martins, Maria Elisabete; Cordovil, Rita; Oliveira, Raúl; Pinho, Joana; Vaz, João RHemiplegia is a form of spastic Cerebral Palsy in which one side of the body is affected, resulting in an atypical body posture and abnormal gait patterns. The purpose of this case-report was to provide a descriptive analysis of the immediate effects of a dynamic orthosis, the TheraSuit® (TS), in gait kinematics. A 5.88 years old child with left spastic hemiplegia, level II (GMFCS) and gait classification type III, was instructed to walk at a self-selected pace along a 10m walkway in two conditions: 1) BL (Baseline); 2) TS (wearing the TS). Two video-digital cameras (Basler piA1000-48gс GigE) and six infrared cameras (VICON T10), sampled at 100 Hz were used. Spatiotemporal parameters and lower limb joint angles were determined. For the spatiotemporal parameters, the TS reduced gait cadence (BL: 156 +/- 10.1 steps/min; TS: 132 +/- 3.4 steps/min). While the TS showed few changes in terms of the spatiotemporal parameters, the lower limb joint kinematics looked to be more affected towards a more functional gait pattern. The joints' motion looked to be altered throughout the gait cycle. At the initial contact, the TS showed i) a reduction of dorsiflexion on non-paretic side (BL: 10.2 deg +/- 3.4; TS: 9.2 deg +/- 1.5) and plantarflexion on paretic side (BL: -5.8 deg +/- 1.1; TS: 9.3 deg +/- 1.4); ii) a reduced knee flexion angle in both limbs; iii) a reduced hip flexion in the non-paretic limb. During the stance phase, the child was able to decrease the flexion pattern by showing more knee extension in the paretic limb and greater hip extension in both limbs. In the swing phase, a decrease in knee and hip flexion in the non-paretic limb was also verified. This case-report shows that TS seems to be able of changing gait kinematics toward a more functional gait pattern (i.e., reducing hip and knee flexion and the amount of plantarflexion). It was particularly clear at a distal level (i.e., ankle). The TS might be an interesting tool to implement in physical therapy programs. However, further investigation is required to better understand its short and long term effects.