Selection criteria for surgical correction of equinovarus foot in adults with brain damage: A systematic scoping review

Chan, Barbara P.; Salib, Marianne; Faggianelli, Florence; Marqué, P.; Cormier, Camille; Gasq, David

doi:10.1016/j.rehab.2022.101651

Cited by 4 publications

(1 citation statement)

References 67 publications

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“…Several spasticity-reducing surgical procedures, which include tenodesis, tendon lengthening, and/or transfer and release of tendon/muscle, may be applied to selected cases of focal spasticity, but evidence supporting their efficacy in spasticity is poor [79 ▪ ], and selection criteria to indicate which patients could benefit lack [80].…”

Section: Treatment Of Spasticitymentioning

confidence: 99%

Spasticity following brain and spinal cord injury: assessment and treatment

Tamburin

Filippetti

Mantovani

et al. 2022

Current Opinion in Neurology

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Purpose of reviewSpasticity is a common sequela of brain and spinal cord injury and contributes to disability, reduces quality of life, and increases economic burden. Spasticity is still incompletely recognized and undertreated. We will provide an overview of recent published data on the definition, assessment, and prediction, therapeutic advances, with a focus on promising new approaches, and telemedicine applications for spasticity.Recent findingsTwo new definitions of spasticity have been recently proposed, but operational criteria should be developed, and test–retest and inter-rater reliability should be explored. Cannabinoids proved to be effective in spasticity in multiple sclerosis, but evidence in other types of spasticity is lacking. Botulinum neurotoxin injection is the first-line therapy for focal spasticity, and recent literature focused on optimizing its efficacy. Several pharmacological, interventional, and nonpharmacological therapeutic approaches for spasticity have been explored but low-quality evidence impedes solid conclusions on their efficacy. The recent COVID-19 pandemic yielded guidelines/recommendations for the use of telemedicine in spasticity.SummaryDespite the frequency of spasticity, robust diagnostic criteria and reliable assessment scales are required. High-quality studies are needed to support the efficacy of current treatments for spasticity. Future studies should explore telemedicine tools for spasticity assessment and treatment.

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Section: Treatment Of Spasticitymentioning

confidence: 99%

Spasticity following brain and spinal cord injury: assessment and treatment

Tamburin

Filippetti

Mantovani

et al. 2022

Current Opinion in Neurology

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Inertial measurement units to evaluate the efficacity of Equino Varus Foot surgery in post stroke hemiparetic patients: a feasibility study

de l’Escalopier,

Voisard,

Jung

et al. 2024

J NeuroEngineering Rehabil

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Introduction This study evaluates the gait analysis obtained by Inetial Measurement Units (IMU) before and after surgical management of Spastic Equino Varus Foot (SEVF) in hemiplegic post-stroke patients and to compare it with the functional results obtained in a monocentric prospective cohort. Methods Patients with post-stroke SEVF, who underwent surgery in a single hospital between November 2019 and December 2021 were included. The follow-up duration was 6 months and included a functional analysis using Goal Attainment Scaling (GAS) and a Gait analysis using an innovative Multidimensional Gait Evaluation using IMU: the semiogram. Results 20 patients had a gait analysis preoperatively and at 6 months postoperatively. 90% (18/20) patients had a functional improvement (GAS T score ≥ 50) and 50% (10/20) had an improvement in walking technique as evidenced by the cessation of the use of a walking aid (WA). In patients with functional improvement and modification of WA the change in the semiogram area was + 9.5%, sd = 27.5%, and it was + 15.4%, sd = 28%. In the group with functional improvement without change of WA. For the 3 experiences (two patients) with unfavorable results, the area under the curve changed by + 2.3%, -10.2% and − 9.5%. The measurement of the semiogram area weighted by average speed demonstrated very good reproducibility (ICC(1, 3) = 0.80). Discussion IMUs appear to be a promising solution for the assessment of post-stroke hemiplegic patients who have undergone SEVF surgery. They can provide a quantified, objective, reliable in individual longitudinal follow up automated gait analysis solution for routine clinical use. Combined with a functional scale such as the GAS, they can provide a global analysis of the effect of surgery.

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ToulGaitViz: a tool for the systematic description of lower limb clearance during the swing phase of hemiparetic gait after stroke. A cohort study

MONTANÉ,

CORMIER,

SCANDELLA

et al. 2024

Eur J Phys Rehabil Med

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BACKGROUND In post-stroke hemiparetic subjects, a systematic and quantified description of the shortening default and compensatory movements during the swing phase of gait is essential to guide treatments and assess the impact of therapeutic interventions. However, such a systematic approach does not exist in the current clinical practice. AIM The aim of this study was to present a method improving the quantification and visualization of the kinematics of both lower limbs during the swing phase of gait, more specifically the origin of shortening default and the weight of compensations, based on a tool specifically developed: ToulGaitViz. DESIGN Observational cohort study. SETTING Three-dimensional kinematic gait analyses of outpatients evaluated in Toulouse university hospital. POPULATION ToulGaitViz was applied to 151 post-stroke hemiparetic participants and 48 healthy control participants. METHODS ToulGaitViz is a standalone software allowing to compute 1) limb clearance as the sum of the shortening related to hip, knee and ankle flexion in the sagittal plane; 2) compensations related to the abduction of the limb and hip hiking at mid-swing. Both centimetric and angular values of the clearance were reported as well as their correlations with walking speed. RESULTS Overall, the contribution of compensations in clearance was higher in post-stroke hemiparetic subjects than in healthy control participants with both centimetric (130% vs. 33%; P<0.001) and angular methods (23% vs. 1.4%; P<0.001). The centimetric method better represents the specific contribution of each segment to the clearance than the angular method. Symbolically, mean kinematic data from the cohort supports the claim that 2° of pelvic obliquity is equivalent to 10° of knee flexion to increase clearance by 1 cm, emphasizing the non-proportionality between the angular values and the actual contribution to the shortening. ToulGaitViz allows visualization of clearance, segmental shortening and compensation evolution before and after any therapeutic intervention with quantitative and comprehensive data. CONCLUSIONS The ToulGaitViz could be systematically used in clinical practice to extract relevant kinematic data from the origin of shortening default and the weight of compensations. CLINICAL REHABILITATION IMPACT This tool allows better understanding of the mechanisms of action of treatments to better link them to the subjects’ needs.

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Selection criteria for surgical correction of equinovarus foot in adults with brain damage: A systematic scoping review

Cited by 4 publications

References 67 publications

Spasticity following brain and spinal cord injury: assessment and treatment

Spasticity following brain and spinal cord injury: assessment and treatment

Inertial measurement units to evaluate the efficacity of Equino Varus Foot surgery in post stroke hemiparetic patients: a feasibility study

ToulGaitViz: a tool for the systematic description of lower limb clearance during the swing phase of hemiparetic gait after stroke. A cohort study

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