Table G.2What is the effectiveness of orthotic interventions (for example, ankle-foot orthoses, knee splints, and upper limb orthoses) as compared to no orthoses to optimise movement and function, to prevent or treat contractures in children with spasticity and with or without other motor disorders caused by a non-progressive brain disorder?

Bibliographic informationReason for exclusion
Balaban,B., Yasar,E., Dal,U., Yazicioglu,K., Mohur,H., Kalyon,T.A., The effect of hinged ankle-foot orthosis on gait and energy expenditure in spastic hemiplegic cerebral palsy, Disability and Rehabilitation, 29, 139-144, 2007comparison not relevant hinged orthoses versus none
Bjornson,K.F., Schmale,G.A., damczyk-Foster,A., McLaughlin,J., The effect of dynamic ankle foot orthoses on function in children with cerebral palsy, Journal of Pediatric Orthopaedics, 26, 773-776, 2006RCT - Comparison not requested (DAFO versus no DAFO)
Blair,E., Ballantyne,J., Horsman,S., Chauvel,P., A study of a dynamic proximal stability splint in the management of children with cerebral palsy, Developmental Medicine and Child Neurology, 37, 544-554, 1995Not randomised
Boyd,R.N., Dobson,F., Parrott,J., Love,S., Oates,J., Larson,A., Burchall,G., Chondros,P., Carlin,J., Nattrass,G., Graham,H.K., The effect of botulinum toxin type A and a variable hip abduction orthosis on gross motor function: a randomized controlled trial, European Journal of Neurology, 8 Suppl 5, 109-119, 2001Comparison not relevant - current treatment versus current treatment + BoNT + SWASH
Brunner,R., Meier,G., Ruepp,T., Comparison of a stiff and a spring-type ankle-foot orthosis to improve gait in spastic hemiplegic children, Journal of Pediatric Orthopaedics, 18, 719-726, 1998Not randomised
Centre for Reviews and Dissemination., A review of the efficacy of lower-limb orthoses used for cerebral palsy (Structured abstract), Database of Abstracts of Reviews of Effects, -, 2010Systematic review already identified
Crenshaw,S., Herzog,R., Castagno,P., Richards,J., Miller,F., Michaloski,G., Moran,E., The efficacy of tone-reducing features in orthotics on the gait of children with spastic diplegic cerebral palsy, Journal of Pediatric Orthopaedics, 20, 210-216, 2000Comparison not relevant - hinged AFO versus rigid TR footplate versus SMO versus SMO footplate versus barefoot
Desloovere K, Molenaers G, Van Gestel L, Huenaerts C, Van Campenhout A, Callewaert B, Van de Walle P, Seyler J. How can push-off be preserved during use of an ankle foot orthosis in children with hemiplegia? A prospective controlled study.Gait Posture. 2006 Oct;24(2):142-51No relevant comparison - PLS versus dual carbon fibre spring AFO versus barefoot and shoes
Elliott C, Reid S, Hamer P, Alderson J, Elliott B. Lycra(®) arm splints improve movement fluency in children with cerebral palsy, Gait Posture. 2011 Feb;33(2):214-9. Epub 2010 Dec 4.Outcomes are not relevant to this review
Exner, C.E. & Bonder, B.R. (1983). Comparative effects of three hand splints on bilateral hand use, grasp, and arm-hand posture in hemiplegic children: A pilot study, The Occupational Therapy Journal of Research, 3, 75-92.No comparator group
Figueiredo,E.M., Ferreira,G.B., Maia,MoreiraR, Kirkwood,R.N., Fetters,L., Efficacy of ankle-foot orthoses on gait of children with cerebral palsy: systematic review of literature, Pediatric Physical Therapy, #20, -223, 2008Systematic review - checked for relevant references and excluded
Flegle,J.H., Leibowitz,J.M., Improvement in grasp skill in children with hemiplegia with the MacKinnon splint, Research in Developmental Disabilities, 9, 145-151, 1988Comparison across groups not presented
Graham,H.K., Boyd,R., Carlin,J.B., Dobson,F., Lowe,K., Nattrass,G., Thomason,P., Wolfe,R., Reddihough,D., Does botulinum toxin a combined with bracing prevent hip displacement in children with cerebral palsy and “hips at risk”? A randomized, controlled trial, Journal of Bone and Joint Surgery - American Volume, 90, 23-33, 2008Comparison does not distinguish between the effects of BoNT and hip brace (BoNT + hip brace versus no treatment)
Hainsworth,F., Harrison,M.J., Sheldon,T.A., Roussounis,S.H., A preliminary evaluation of ankle orthoses in the management of children with cerebral palsy, Developmental Medicine and Child Neurology, 39, 243-247, 1997No relevant outcomes reported versus no daytime orthoses
Han SH, Kim T, Jang SH, Kim MJ, Park SB, Yoon SI, Choi BK, Lee MY, Lee KH. The effect of an arm sling on energy consumption while walking in hemiplegic patients: a randomized comparison, Clin Rehabil. 2011 Jan;25(1):36-42.Study conducted in an adult population
Hazneci,B., Tan,A.K., Guncikan,M.N., Dincer,K., Kalyon,T.A., Comparison of the efficacies of botulinum toxin A and Johnstone pressure splints against hip adductor spasticity among patients with cerebral palsy: a randomized trial, Military Medicine, 171, 653-656, 2006Comparison not relevant - BoNT versus Johnstone Pressure Splints
Kerem,M., Livanelioglu,A., Topcu,M., Effects of Johnstone pressure splints combined with neurodevelopmental therapy on spasticity and cutaneous sensory inputs in spastic cerebral palsy, Developmental Medicine and Child Neurology, 43, 307-313, 2001Not randomised
Lam,W.K., Leong,J.C.Y., Li,Y.H., Hu,Y., Lu,W.W., Biomechanical and electromyographic evaluation of ankle foot orthosis and dynamic ankle foot orthosis in spastic cerebral palsy, Gait and Posture, 22, 189-197, 2005No acclimatisation period for use of AFO prior to testing
Lannin,N., Scheinberg,A., Clark,K., AACPDM systematic review of the effectiveness of therapy for children with cerebral palsy after botulinum toxin A injections, Developmental Medicine and Child Neurology, 48, 533-539, 2006Systematic review - checked for relevant references and excluded
Maltais,D., Bar-Or,O., Galea,V., Pierrynowski,M., Use of orthoses lowers the O(2) cost of walking in children with spastic cerebral palsy, Medicine and Science in Sports and Exercise, 33, 320-325, 2001Comparison not relevant hinged AFO versus shoes
Morris,C., A review of the efficacy of lower-limb orthoses used for cerebral palsy, Developmental Medicine and Child Neurology, 44, -211, 2002Systematic review - checked for relevant references and excluded
Mossberg,K.A., Linton,K.A., Friske,K., Ankle-foot orthoses: Effect on energy expenditure of gait in spastic diplegic children, Archives of Physical Medicine and Rehabilitation, 71, 490-494, 1990no acclimatisation period for use of AFO
Nicholson,J.H., Morton,R.E., Attfield,S., Rennie,D., Assessment of upper-limb function and movement in children with cerebral palsy wearing lycra garments, Developmental Medicine and Child Neurology, 43, 384-391, 2001Case series
Ounpuu S, Bell KJ, Davis RB 3rd, DeLuca PA. An evaluation of the posterior leaf spring orthosis using joint kinematics and kinetics. J Pediatr Orthop. 1996 May-Jun;16(3):378-84.Retrospective study
Park ES, Park CI, Chang HJ, Choi JE, Lee DS.The effect of hinged ankle-foot orthoses on sit-to-stand transfer in children with spastic cerebral palsy. Arch Phys Med Rehabil. 2004 Dec;85(12):2053-7.Comparison is not relevant to this review : hinged AFO versus barefoot
Radtka,S.A., Skinner,S.R., Dixon,D.M., Johanson,M.E., A comparison of gait with solid, dynamic, and no ankle-foot orthoses in children with spastic cerebral palsy, Physical Therapy, 77, 395-409, 1997not randomised
Reid DT, Sochaniwskyj A. Influences of a hand positioning device on upper-extremity control of children with cerebral palsy, Int J Rehabil Res. 1992;15(1):15-29.Outcomes are not relevant to this review
Ridgewell,E., Dobson,F., Bach,T., Baker,R., A systematic review to determine best practice reporting guidelines for AFO interventions in studies involving children with cerebral palsy, Prosthetics and Orthotics International, 34, 129-145, 2010Systematic review - checked for relevant references and excluded
Romkes J, Brunner R. Comparison of a dynamic and a hinged ankle-foot orthosis by gait analysis in patients with hemiplegic cerebral palsy, Gait Posture. 2002 Feb;15(1):18-24.Randomisation not confirmed
Smiley SJ, Jacobsen FS, Mielke C, Johnston R, Park C, Ovaska GJ. A comparison of the effects of solid, articulated, and posterior leaf-spring ankle-foot orthoses and shoes alone on gait and energy expenditure in children with spastic diplegic cerebral palsy, Orthopedics. 2002 Apr;25(4):411-5Randomisation within study not confirmed
Smith,P.A., Hassani,S., Graf,A., Flanagan,A., Reiners,K., Kuo,K.N., Roh,J.Y., Harris,G.F., Brace evaluation in children with diplegic cerebral palsy with a jump gait pattern, Journal of Bone and Joint Surgery - American Volume, 91, 356-365, 2009Comparison not relevant - DAFO, HAFO, Control, barefoot
Suzuki N, Shinohara T, Kimizuka M, Yamaguchi K, Mita K. Energy expenditure of diplegic ambulation using flexible plastic ankle foot orthoses, Bull Hosp Jt Dis. 2000;59(2):76-80.Comparison not relevant - flexible plastic AFO versus shoes
utti-Ramo,I., Suoranta,J., Anttila,H., Malmivaara,A., Makela,M., Effectiveness of upper and lower limb casting and orthoses in children with cerebral palsy: An overview of review articles, American Journal of Physical Medicine and Rehabilitation, 85, 89-103, 2006Systematic review - checked for relevant references and excluded
Wesdock,Kimberly A., Edge,Annabel M., Effects of Wedged Shoes and Ankle-Foot Orthoses on Standing Balance and Knee Extension in Children with Cerebral Palsy Who Crouch, Pediatric Physical Therapy, 15, -, 2003Not randomised

From: Appendix H, Excluded studies

Cover of Spasticity in Children and Young People with Non-Progressive Brain Disorders
Spasticity in Children and Young People with Non-Progressive Brain Disorders: Management of Spasticity and Co-Existing Motor Disorders and Their Early Musculoskeletal Complications.
NICE Clinical Guidelines, No. 145.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2012 Jul.
Copyright © 2012, National Collaborating Centre for Women's and Children's Health.

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