Duchenne Muscular Dystrophy (DMD) muscular dystrophy
Conditions
Interventions
In the intervention study a dynamic ankle-foot orthosis of OIM (Orthopedische
Instrumentmakerij, type *spring swing*) will be used. This brace is made of
polypropylene and has a spring attached on t
Sponsors
Universitair Medisch Centrum Sint Radboud
Eligibility
Age
2 Years to 11 Years
Inclusion criteria
Inclusion criteria: The study will include at least 6 boys with DNA established diagnosis of Duchenne Muscular Dystrophy walking with minor impairments and unsupported in the community at least for 6 minutes, e.g. Vignos 1-3. Expected is that the age range will be between 6 and 8 years.
Exclusion criteria
Exclusion criteria: Excluded are boys with DMD in combination with other disabling diseases. A questionnaire is sent prior to inclusion to check these items.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Observational study Primary outcome is to describe the correlation between contractures of the ankle and gait. Children will walk on their toes to create an external extension moment on the knee and thus stability, leading to ankle contractures. Ankle contractures will hypothetically cause a greater plantar flexion moment at the end of the lengthening phase, creating a push-off at heel rise. The results will be compared to the findings of Gaudreault et al. (2009). 2. Intervention study In the intervention study, gait analysis is repeated in exactly the same way, only this time with AFO*s on both sides. Primary outcome: Change of the functional measures in walking with and without the dynamic AFO, such as gait velocity, timed motor performances and fatigue with non-parametric statistics. Expected is that with the AFO*s children will improve the 6 minute walking test (6MWT) with 10%. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Observational study We suspect to find the following correlations: • A positive correlation of PROM of the ankle and foot clearance during swing. A contracture of the Achilles tendon will complicate foot clearance. • A negative correlation of PROM of the ankle and passive plantar flexion moment at the end of the lengthening phase. A contracture of the Achilles tendon will store energy while tensed, causing a passive plantar flexion moment at the end of the lengthening phase. 2. Intervention study Secondary outcomes: • Change of clearance of the foot, circumduction and pelvic tilt during swing phase with use of the dynamic ankle-foot orthosis versus walking without braces. Expected is to find a positive effect of the AFO*s. • Change of stride length, cadence and gait velocity using the AFO*s. Expected is to find a positive effect of the AFO*s. • Positive correlation of PROM and the strength of the spring of the dynamic AFO needed to achieve clearance in swing phase | — |
Countries
Netherlands
Outcome results
None listed