Assessment of Hip Abductor Power in Patients With Foot Drop

Jeon, Chang-Hoon; Chung, Nam-Su; Lee, Yu-Sang; Son, Kwang-Hyun; Kim, Junho

doi:10.1097/brs.0b013e318268c8bc

Cited by 24 publications

(1 citation statement)

References 24 publications

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“…As the gluteus muscle is mostly innervated by the lumbosacral plexus, assessment of hip abductor muscle strength in foot drop patients is useful in differentiating CPN palsy and lumbar radiculopathy, with 85.7% sensitivity and 96.4% specificity7). The author also believes that as ankle foot motion is variable or patients are not accustomed to specific ankle motions, such as ankle inversion or eversion, it is useful to evaluate the strength of muscles that CPN does not innervate.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Peroneal Nerve Palsy by Posture

Yang

Kang

et al. 2013

J Korean Neurosurg Soc

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ObjectivePosture induced common peroneal nerve (CPN) palsy is usually produced during the prolonged squatting or habitual leg crossing while seated, especially in Asian culture and is manifested by the onset of foot drop. Because of its similarity to discogenic foot drop, patients may be diagnosed with a lumbar disc disorder, and in some patients, surgeons may perform unnecessary examinations and even spine surgery. The purpose of our study is to establish the clinical characteristics and diagnostic assessment of posture induced CPN palsy.MethodsFrom June 2008 to June 2012, a retrospective study was performed on 26 patients diagnosed with peroneal nerve palsy in neurophysiologic study among patients experiencing foot drop after maintaining a certain posture for a long time.ResultsThe inducing postures were squatting (14 patients), sitting cross-legged (6 patients), lying down (4 patients), walking and driving. The mean prolonged neural injury time was 124.2 minutes. The most common clinical presentation was foot drop and the most affected sensory area was dorsum of the foot with tingling sensation (14 patients), numbness (8 patients), and burning sensation (4 patients). The clinical improvement began after a mean 6 weeks, which is not related to neural injury times. Electrophysiology evaluation was performed after 2 weeks later and showed delayed CPN nerve conduction study (NCS) in 24 patients and deep peroneal nerve in 2 patients.ConclusionWe suggest that an awareness of these clinical characteristics and diagnostic assessment methods may help clinicians make a diagnosis of posture induced CPN palsy and preclude unnecessary studies or inappropriate treatment in foot drop patients.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Peroneal Nerve Palsy by Posture

Yang

Kang

et al. 2013

J Korean Neurosurg Soc

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Evaluating Lumbar Radiculopathy

Talmage¹,

Eskay-Auerbach²,

Blaisdell³

2014

AMA Guides® Newsletter

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For workers’ compensation, most requests for a permanent impairment rating of low back injuries involve the diagnostic labels of nonspecific chronic low back pain or intervertebral disk herniation. Use of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, to choose the right diagnosis and class for these injuries is the first step and involves correctly choosing between “nonverifiable radicular complaints” and “residual radiculopathy.” Evaluators must be able to distinguish persisting radiculopathy, as defined in the sixth edition, from resolved radiculopathy and from nonverifiable radicular complaints and to support findings with objective clinical evidence. Clinical evidence of chronic radiculopathy might include motor weakness, muscle atrophy, impaired sharp–dull discrimination, and/or abnormal electrodiagnostic tests, provided the findings are persistent and there are reflex abnormalities. When considering radiculopathy in the appropriate spine grid of the AMA Guides, Sixth Edition, the evaluator must distinguish radicular (limb) symptoms that are continuous, intermittent, or completely resolved. Positive electromyography (EMG) studies for acute radiculopathy are a sufficient objective finding to state the person has radiculopathy on the date of the test; individuals with positive needle EMG do have persisting radiculopathy at maximum medical improvement, but this does not mean that radiculopathy must persist despite time and treatment.

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