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Authors: O.L. Belyanin, A.A. Koltsov, E.I. Jomardly, N.V. Marusin. 
Institutions: Federal State Budgetary Institution «Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht» of the Ministry of Labour and Social Protection of the Russian Federation.
Year: 2018
Publication: Rehabilitation – XXI century: traditions and innovations: a collection of articles II National Congress with international participation, St. Petersburg, 12-13 September 2018 / Ministry of Labor of Russia.
Abstract:
The influence of orthopedic apparatus use on biomechanical parameters of walking fro children with spastic forms of infantile cerebral palsy with motor activity level 1-3 on GMFCS scale was assessed.

Spasticity is the most frequent symptom of infantile cerebral palsy (cerebral palsy). Spastic forms of cerebral palsy account for at least 80% of all cases and are characterized by early appearance of pathological units and deformations that lead to violations of biomechanical parameters of support and movement. Within the context of comprehensive medical rehabilitation, various methods of rehabilitation and surgical treatment are widely used, and one of the most important aspects of rehabilitation is the use of technical equipment for rehabilitation. Taking into view the complex nature of the pathology and variety of clinical symptoms, the spectrum of rehabilitation equipment is significant. And one of the most important groups are orthoses, and among orthoses – apparatuses for lower limbs of various constructions. Application of biomechanical methods of analyzing the effectiveness of the equipment used at various stages of complex medical rehabilitation allows to objectively assess the impact of certain orthoses on the patient’s ability to self-care.

The purpose of the study:
Estimate the impact of orthopedic apparatus use on the lower limbs and torso on biomechanical walking parameters for children with spastic forms of cerebral palsy.

Materials and methods:
For the period from November 2017 to July 2018, 412 patients with spastic forms of cerebral palsy aged 1 to 17 years were treated. This trial was conducted in 24 patients aged 3 – 17 years. The selection criteria were: age over 3 years, 1-3 motor activity level according to GMFCS, spasticity level according to the Ashworth scale from 1 to 3, musculoskeletal surgical treatment and/or CNS in an anamnesis at least 1 year old, botulinum therapy in anamnesis at least 6 months old. Among 24 patients surveyed 3 patients (12.5%) had the 1st level, 9 patients (37.5%) had the 2nd level, 12 patients (50.0%) had the 3rd level. evel 3 motor activity by GMFCS.

Results and discussions:
In patients with the level of motor activity of GMFCS-1, the main changes in biomechanical parameters were an increase in step width and change in foot rotation angle when using devices on the lower extremities and torso.

Conclusion:
Due to the fact that the study groups have identified patients whose biomechanical parameters deviate from the general trend, it is advisable to continue research on a larger sample of patients, taking into account the age groups, prevailing deformities, the presence or absence of surgical interventions on the musculoskeletal system, as well as before, during and after the action of botulinum toxin.

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