Working as a pediatric physical therapist, Teresa Pierce, PT, DPT, PCS, has the opportunity to assist children with cerebral palsy. Children with this neurological condition often experience difficulty with movement, gait and postural control.
“Foot/ankle bracing (orthoses) is often recommended to assist with gait stability, speed and efficiency,” Pierce said
However, Pierce noticed many children had difficulty wearing the braces due to discomfort and skin/joint breakdown when the braces were set at the typical 90-degree (plantigrade) angle.
“Many children with cerebral palsy cannot achieve a neutral ankle, particularly when their knee is extended,” she said.
Pierce learned of a practitioner in the United Kingdom named Elaine Owen who began using an optimized approach to foot/ankle bracing in children with neurological diagnoses. This approach accommodates ankle range of motion and muscle length, while facilitating efficient gait patterns that more closely align with typical gait patterns. Pierce began attending Owen’s educational courses and traveled to London in 2022 to observe Owen's approach at the London Orthotic Consultancy.
“When I performed a literature review, I found that this approach had not been empirically tested, so I designed a study protocol to compare gait biomechanics and function in this population when wearing optimized orthoses and non-optimized orthoses,” Pierce said.
The study, she explained, explores differences in walking in children with cerebral palsy when wearing two different pairs of foot/ankle braces.
According to Pierce, results from this study could help clinicians prescribe better bracing, which would promote more efficient walking for children with cerebral palsy. Findings could also provide preliminary data for larger future studies, she added.
Pierce has always been interested in research, but she credits completing a PhD with providing the foundation and training for properly planning and performing research studies. Now, as an assistant professor with the Doctor of Physical Therapy program at PCOM Georgia, she describes the time and energy spent on research pursuits as “worthwhile and important for knowledge acquisition for all stakeholders.”
“The vision for the physical therapy profession is to transform society by optimizing movement to improve the human experience,” Pierce said. “Finding out about how different bracing impacts function is important as children with cerebral palsy could benefit from advances in movement optimization.”
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