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Critical Reviews™ in Physical and Rehabilitation Medicine

ISSN for PRINT: 0896-2960

Institutional price:	$684.00
Issues per year:	4

Best Paper Award Selection - Editorial Board Site

2007, Volume19

82 pages

DOI: 10.1615/CritRevPhysRehabilMed.v19.i3

Issue price - $190.00

The Treatment of Spastic Equinovarus Foot after Stroke

Thierry Deltombe
Department of Physical Medicine and Rehabilitation, Université Catholique de Louvain, Cliniques Universitaires de Mont-Godinne, B-5530 Yvoir, Belgium

Thierry Gustin
Department of Neurosurgery, Université Catholique de Louvain, Cliniques Universitaires de Mont-Godinne, B-5530 Yvoir, Belgium

Philippe De Cloedt
Department of Orthopedic Surgery, Université Catholique de Louvain, Cliniques Universitaires de Mont-Godinne, B-5530 Yvoir, Belgium

Maryse Vandemeulebroecke
Department of Physical Medicine and Rehabilitation, Université Catholique de Louvain, Cliniques Universitaires de Mont-Godinne, B-5530 Yvoir, Belgium

Philippe Hanson
Department of Physical Medicine and Rehabilitation, Université Catholique de Louvain, Cliniques Universitaires de Mont-Godinne, B-5530 Yvoir, Belgium

ABSTRACT

Spastic equinovarus foot (SEF) is a major cause of disability in stroke patients. Treatments are multimodal and include rehabilitation, orthosis, botulinum toxin injections, alcohol and phenol nerve blocks, functional neurosurgery (neurotomy and intrathecal baclofen) and orthopedic surgery (tendon transfer or lengthening). Precise knowledge of the cause of the equinovarus deformity (muscle spasticity, shortening, and/or weakness) with clinical examination, diagnostic nerve blocks with anesthetics, and gait analysis may help to determine the most appropriate treatment for each patient. This article summarizes current approaches to the assessment and treatment of SEF. In contrast with the number of treatments available, there are a lack of comparative studies to guide therapeutic decisions, which actually depend more on personal experience than on scientific guidelines.