Resistance Treatment Reduces Crouching in Patients With CP

Keith M. Smith, CO, LO, FAAOP
Keith M. Smith

CHICAGO — Resistance-based orthotic treatments should replace those that stop ankle motion for patients with cerebral palsy, according to a presenter at The American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium.

“Crouch gait and challenging — I think they are synonymous for each other,” Keith M. Smith, CO, LO, FAAOP, said in a presentation here.

In a child with crouch gait, he or she rises up on the balls of the toes with bent knees as he or she grows, getting more crouched. Traditional treatment for these patients attempts to stop the knees from bending, which only causes the patient to lean on the toes to restore balance. This result is not an improvement, Smith said.

“We constantly have battles with different therapists and orthotists. Should we be trying to accommodate these situations? Should we be trying to correct these deformities?” he said.

To correct this tendency, Smith treated his patient with an adjustable dynamic response component, which provided slight resistance against the knee’s natural tendency to bend, reducing knee contracture from -35 to -20 and bringing the patient into a more upright stance.

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