Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 2, 2016
   Pages 219 — 228

Abstract — Plantar pressure displacement after anesthetic motor block and tibial nerve neurotomy in spastic equinovarus foot

Nathalie Khalil, MD;1* Claudie Chauvière, PT;1 Loïc Le Chapelain, MD, PhD;1 Hélène Guesdon, MD;1 Elodie Speyer, PhD;2 Hervé Bouaziz, MD, PhD;3 Didier Mainard, MD, PhD;4 Jean-Marie Beis, MD, PhD;1 Jean Paysant, MD, PhD1

1Institut Régional de Médecine Physique et de Réadaptation Nancy, Centre de Médecine Physique et de Réadaptation, Lay Saint Christophe, France; 2Service d'Epidémiologie et Evaluation cliniques, 3Service d'Anesthésie-réanimation chirurgicale, and 4Service de Chirurgie orthopédique, traumatologique et arthroscopique, Centre Hospitalier Universitaire Nancy, Nancy, France

Abstract — The aim of this study was to analyze the displacements of center of pressure (COP) using an in-shoe recording system (F-Scan) before and after motor nerve block and neurotomy of the tibial nerve in spastic equinovarus foot. Thirty-nine patients (age 45 +/– 15 yr) underwent a motor nerve block; 16 (age 38 +/– 15.2 yr) had tibial neurotomy, combined with tendinous surgery (n = 9). The displacement of the COP (anteroposterior [AP], lateral deviation [LD], posterior margin [PM]) was compared between paretic and nonparetic limbs before and after block and surgery. At baseline, the nonparetic limb had a higher AP (17.3 vs 12.3 cm, p < 0.001) and LD (4.0 vs 3.3 cm, p = 0.001) and a smaller PM (2.9 vs 4.7 cm, p = 0.001). For the paretic limb, a significant increase of AP was observed after block (13.5 vs 12.3 cm, p = 0.02) and after surgery (13.7 vs 12.3 cm, p = 0.03). A significant decrease of PM was observed after surgery (4.5 vs 3.3 cm, p < 0.001) with no more difference between two limbs (2.8 vs 3.3 cm, p = 0.44). This study shows that the F-Scan system can be used to quantify impairments and be useful to evaluate the effects of treatment for spastic foot. It suggests that changes in AP displacement following block may predict the effects of neurotomy.

Key words: anesthesic motor block, baropodometry, F-Scan sensor system, gait, hemiplegic, insole sensors, plantar pressure, spastic equinovarus foot, stroke, tibial nerve neurotomy.


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This article and any supplementary material should be cited as follows:
Khalil N, Chauvière C, Le Chapelain L, Guesdon H, Speyer E, Bouaziz H, Mainard D, Beis JM, Paysant J. Plantar pressure displacement after anesthetic motor block and tibial nerve neurotomy in spastic equinovarus foot. J Rehabil Res Dev. 2016;53(2):219–28.
http://dx.doi.org/10.1682/JRRD.2014.11.0298
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