Article

The aim of the study was to compare the effect of diagnostic motor
nerve block with anaesthetics and of selective tibial neurotomy in the treatment
of spastic equinovarus foot in hemiplegic adults. In this prospective
observational study, 30 hemiplegic adults with spastic equinovarus foot benefited
from a diagnostic nerve block with anaesthetics followed by a selective tibial
neurotomy performed at the level of the same motor nerve branches of the tibial
nerve. Spasticity (Ashworth scale), muscle strength (Medical Research Council
scale), passive ankle dorsiflexion (ROM), gait parameters (10 meters walking
test) and gait kinematics (video assessment) were assessed before and after the
nerve block and two months and two years after selective tibial neurotomy.
RESULTS: The decrease in spasticity and the improvement in gait kinematics were
similar after the diagnostic nerve block and two months and two years after
neurotomy. The diagnostic nerve block did not revealed the slight increase in
gait speed and in tibialis anterior muscle strength that was observed two years
after neurotomy. CONCLUSION: This study suggests that diagnostic nerve block with
anaesthetics and selective neurotomy equally reduce spasticity and improve gait
in case of spastic equinovarus foot in hemiplegic adults. Diagnostic nerve block
can be used as a valuable screening tool before neurotomy.
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Langue : ANGLAIS