NEW ORLEANS — A study of children with myelomeningocele using AFOs under a dual task paradigm has provided new insight on the day-to-day functional effect of AFOs on this population, according to Nikta Pirouz, CPO, who led the study at Ann and Robert H. Lurie Children’s Hospital of Chicago.
Pirouz’s presentation was one of two selected for this year’s Thranhardt Lecture Series here at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium.
Pirouz said her research builds on past studies showing that AFOs can improve the gait, balance, kinematics and energy expenditure of children with myelomeningocele.
“What my research adds is that AFOs are also able to improve performance of non-motor cognitive tasks that are performed during gait,” she said.
Pirouz and colleagues collected data on a group of 16 children with myelomeningocele, ages 7 years to 13 years, performing dual tasks during two visits, 2 weeks apart. Children performed single tasks of walking and of counting, with the level of difficulty of tasks adjusted for each child; and then the dual task of walking and counting together. Children performed the tests with and without AFOs. They wore shoes in both tests.
The researchers found a significant increase in velocity while walking and in correct answers while counting when children wore AFOs while performing dual tasks.
“Our results indicate that the benefits of AFOs are dependent on the tasks and the context in which they are used,” Pirouz said.
Pirouz and colleagues found a statistically significant increase in velocity while walking with the use of AFOs due to an increased stride length. However, the increase in velocity while performing dual tasks was tied to an increase in cadence rather than stride length. Pirouz said this indicates the children chose counting as their primary task and walking as their secondary task, which means the pediatric patient population may prioritize tasks differently than adult patients do.
Pirouz said that because AFOs decrease the physical demands of gait, they allow for improved performance of concurrent tasks.
“Through the pathway of attention, AFOs have an indirect yet meaningful effect on performance of cognitive tasks,” she said. – by Amanda Alexander
Pirouz N. Ankle-foot orthoses for children with myelomeningocele: Functional effects under a dual-task paradigm. Presented at: American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium; Feb. 18-21, 2015; New Orleans.
Disclosure: Pirouz reports no relevant financial disclosures.