Document Detail

Improvement of gait in a stroke patient. A 7-year longitudinal study.
MedLine Citation:
PMID:  20178412     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To report on the gait improvement obtained in a stroke patient after applying three treatments for spastic equinus varus foot: botulinum toxin injection (BTI), tibial nerve neurotomy (TNN), and orthopaedic surgery (triple arthrodesis), during a 7-year longitudinal follow-up period.
METHOD: A quantified analysis of a stroke patient's gait was performed on a Gaitrite walking mat before and after applying BTI 3 years, TNN 4 years and orthopaedic surgery 7 years after the stroke.
RESULTS: After the three treatments, the spasticity disappeared, the range of ankle motion improved and voluntary command of the tibialis anterior became possible. Upon comparing the gait parameters before treatment and after the three treatments, it was observed that the comfortable gait velocity had increased (from 0.42 m/s to 0.70 m/s), the step length had become more symmetrical (from left 19 cm, right 57 cm to left 50 cm, right 51 cm), the step width had decreased (from 23 cm to 12 cm). In terms of participation, walking barefoot had become possible without a cane, as well as going up and down stairs and walking outdoors on uneven ground without any help.
CONCLUSIONS: Stroke patients during the chronic phase with a spastic equinovarus deformity can benefit from various commonly used therapeutic interventions. BTI and TNN were found to be efficient but only for a short time. Orthopaedic surgery gave the most long-lasting results. Further studies should be performed on a larger number of patients to determine the most suitable options for treating stroke patients with an equinus varus foot.
Laurent Bensoussan; Alvina Mathelin; Jean-Michel Viton; Herve Collado; Alain Delarque
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Disability and rehabilitation     Volume:  32     ISSN:  1464-5165     ISO Abbreviation:  Disabil Rehabil     Publication Date:  2010  
Date Detail:
Created Date:  2010-08-23     Completed Date:  2010-12-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9207179     Medline TA:  Disabil Rehabil     Country:  England    
Other Details:
Languages:  eng     Pagination:  1705-11     Citation Subset:  IM    
Department of Physical and Rehabilitation Medicine, Faculty of Medicine, University of the Mediterranean, University Hospital la Timone, Marseille, France.
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MeSH Terms
Botulinum Toxins, Type A / therapeutic use*
Equinus Deformity / drug therapy*,  rehabilitation,  surgery*
Gait Disorders, Neurologic / rehabilitation*
Hemiplegia / rehabilitation
Longitudinal Studies
Muscle Spasticity / rehabilitation
Stroke / rehabilitation*
Tibial Nerve / surgery*
Reg. No./Substance:
EC Toxins, Type A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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