Article

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.

Langue : ANGLAIS