Document Detail

Gait analysis in a patient with severe Charcot-Marie-Tooth disease: a case study with a new orthotic device for footdrop.
MedLine Citation:
PMID:  20927001     Owner:  NLM     Status:  MEDLINE    
Management of footdrop in severe Charcot-Marie-Tooth (CMT) patients is a challenge owing to the combination of quadriceps muscle weakness, distal muscular atrophy, sensory impairment and poor soft tissue resistance to the placement of an orthotic device. We present a case study of a patient who gradually became unable to use his ankle-foot orthoses because they hampered the compensative movements required to stabilize his knees passively and caused pain. The aim of this report is to describe orthotic management in such a severe CMT case and to present a new orthotic device that we devised for the footdrop in this patient. We provided him with 3 different footdrop devices, each of which was highly elastic to allow knee hyperextension, and left him free to decide which one to use: 1) the silicone-ankle-foot orthoses were rapidly discarded because of pain; 2) the Codivilla support was not used because of discomfort and poor aesthetic appearance; 3) a new device, called the "Soft Footdrop Insert" (SFI), consisting of a sheet of Veolform, a reticulated polyolephinic foam, stuck to the counter of midcalf boots, was found to be effective, comfortable, pain-free and aesthetically acceptable, and was consequently used the vast majority of the time. At a 3-year follow-up, an instrumental gait analysis, in which ordinary shoes were compared with the Codivilla support and the SFI, revealed that both the Codivilla support and the SFI controlled footdrop more effectively than ordinary shoes and increased swing and mean velocity; in addition, the SFI yielded the best gait performances. We think that a soft, invisible device, such as the SFI, may satisfy the needs of CMT patients and improve compliance with orthoses-wearing for footdrop.
Paolo Vinci; M Paoloni; F Ioppolo; P Gargiulo; V Santilli
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-05-06
Journal Detail:
Title:  European journal of physical and rehabilitation medicine     Volume:  46     ISSN:  1973-9095     ISO Abbreviation:  Eur J Phys Rehabil Med     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-10-07     Completed Date:  2011-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101465662     Medline TA:  Eur J Phys Rehabil Med     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  355-61     Citation Subset:  IM    
Rehabilitation Service, Italian Charcot-Marie-Tooth Association, Rome, Italy.
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MeSH Terms
Charcot-Marie-Tooth Disease / complications,  physiopathology,  rehabilitation*
Equipment Design
Gait / physiology
Gait Disorders, Neurologic / etiology,  physiopathology,  rehabilitation*
Middle Aged
Orthotic Devices*
Pain / etiology

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