Selective tibial neurotomy in the treatment of spastic equinovarus foot in hemiplegic patients: a 2-year longitudinal follow-up of 30 cases.
Arch Phys Med Rehabil
; 91(7): 1025-30, 2010 Jul.
Article
em En
| MEDLINE
| ID: mdl-20599040
ABSTRACT
OBJECTIVE:
To assess the long-term efficacy of selective tibial neurotomy in the treatment of spastic equinovarus foot in hemiplegic patients.DESIGN:
Intervention study (before-after trial) with an observational design and 2-year follow-up.SETTING:
Spasticity group in a university hospital.PARTICIPANTS:
Hemiplegic patients (N=30) with spastic equinovarus foot. INTERVENTION A selective neurotomy was performed at the level of the motor nerve branches of the tibial nerve. MAIN OUTCOMEMEASURES:
Spasticity (Ashworth scale), muscle strength (Medical Research Council scale), passive ankle dorsiflexion, gait parameters (6 min walking test), and gait kinematics (video assessment) were assessed before and at 2 months, 1 year, and 2 years after selective tibial neurotomy.RESULTS:
Compared with preoperative values, there was a statistically significant decrease in triceps surae spasticity, an increase in gait speed, and a reduction in equinus and varus in swing and stance phases at 2 months postoperatively. This improvement persisted at 1 and 2 years after selective tibial neurotomy. Selective tibial neurotomy does not induce permanent triceps muscle weakness or triceps surae-Achilles' tendon complex shortening.CONCLUSION:
This study confirms the long-lasting beneficial effect of selective tibial neurotomy on spasticity, gait speed, and equinovarus deformity in the treatment of spastic equinovarus foot in hemiplegic patients.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Nervo Tibial
/
Pé Equino
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Hemiplegia
/
Espasticidade Muscular
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article