Article

Charcot-Marie-Tooth disease is an inherited neuropathy causing
progressive weakness, foot deformity and difficulty walking. Clinical anecdotes
suggest orthoses designed on the 'sensorimotor' paradigm are beneficial for
improving gait in Charcot-Marie-Tooth disease. OBJECTIVES: Investigate the effect
of sensorimotor orthoses on in-shoe and lower limb biomechanics in adults with
Charcot-Marie-Tooth disease. STUDY DESIGN: Randomised, repeated-measures,
exploratory study. METHODS: Eight males and two females with Charcot-Marie-Tooth
disease aged 31-68 years fitted with pedorthic shoes and custom-made sensorimotor
orthoses were randomly tested at baseline and after 4 weeks of adaptation.
In-shoe three-dimensional multi-segment foot and lower limb kinematics and
kinetics were collected as were plantar pressures, electromyography and
self-reported comfort, stability, cushioning and preference. RESULTS: Compared to
the shoe only condition, sensorimotor orthoses increased midfoot eversion and
plantarflexion, increased ankle eversion and produced small but significant
changes at the knee and hip indicating increased internal rotation. The orthoses
increased medial ground reaction forces and increased pressure at the heel,
midfoot and toes. There were minimal effects on electromyography. The
sensorimotor orthoses were rated higher for comfort, cushioning, stability and
preference. CONCLUSION: Sensorimotor orthoses produced changes in kinematic,
kinetic and pressure variables in adults with Charcot-Marie-Tooth disease and
were regarded as more comfortable, cushioned and stable during walking. CLINICAL
RELEVANCE: In this study, the walking ability of patients with
Charcot-Marie-Tooth disease improved with the use of foot orthoses designed
according to the sensorimotor paradigm. However, the mechanism of action appears
to be primarily mechanical in origin. Randomised controlled trials are necessary
to evaluate the long-term patient-reported outcomes of sensorimotor orthoses.
CI - (c) The International Society for Prosthetics and Orthotics 2015.

Langue : ANGLAIS