Dynamic flex cast with neurodevelopmental treatment

Rigid Ankle foot Orthosis with neurodevelopmental treatment

Neurodevelopmental therapy in combination with dynamic flex cast to treat experimental group.

Three times a week, 1 hour session per day.

Dynamic flex casting is casting which manipulate bone alignment and maintains range of motion or sustained stretch. Casting will be changed weekly for 3 months.

Neuro developmental approach is individualized treatment which is attuned to each child's specific problems, aims and goals.

Key elements in NDT are: facilitation (using sensory inputs to improve motor performance), management of compensatory motor behavior, and an overall management strategy (a 24-hour interdisciplinary management approach) NDT involves task specific postures and movements.

The original GMFM has 88 items each scored on a 4-point ordinal scale of 0 to 3, where 0 indicates that the child does not initiate the task; 1 indicates that the child initiates the task (completes < 10% activity); 2 indicates that the child partially completes the task (completes from 10 to 99% of activity); 3 indicates that the child completes the task (100%); and NT indicates that the child was not tested. The 88 items are grouped into five dimensions: 1) lying and rolling, 2) sitting, 3) crawling and kneeling, 4) standing, and 5) walking, running and jumping. Reliability with intraclass correlation coeffcient greater than .98 with 0.965--.994 95% confidence interval.

It is used to assess gait deviation. Temporal distance factors including velocity, cadence, stride length, stride width will be assessed.