Title : Characteristics of the management of spastic foot in adult vascular hemiplegic patients: About 102 cases
Abstract:
Introduction: Spasticity of the lower limb occurs in nearly 20% of cases.
In hemiplegic patients, progression to equinovarus foot is the most frequent neuro-orthopedic deformity.
The frequency is estimated at 20%,
80% of patients recover walking ability within 6 months following the vascular accident.
Material and Methods: Our retrospective clinical study included subjects who suffered an ischemic vascular accident, aged between 30 and 87 years, coming from different specialized consultations in physical medicine and rehabilitation, cardiology, neurology, and neurosurgery, during the period from March 2014 to December 2022.
Several parameters were studied, namely: Age, sex, level of education, place of residence, housing, Caregiver, Risk factors and medical history, Side of motor deficit, Time to management, Patients’ complaints, Impact on activities of daily living (ADL) (FIM/FAC) before treatment, Therapeutic means, Impact on ADL (FIM/FAC) after treatment
Discussions: The mean age of our patients was 61.76 years. In our study, we noted that 80% of patients live in a more or less urbanized area. 63% of patients have accessible housing. 92% of patients had medical history, the most important being arterial hypertension and diseases. 80% of patients followed a well-codified physiotherapy protocol including: muscle strengthening, stretching, and inhibitory postures. All patients benefited from a guided self-rehabilitation contract (gsc) explained and illustrated with images.
Conclusion: Spastic foot in hemiplegic patients is the most frequent type of spastic foot. In its functional component, it disrupts activities of daily living, because although 80% of patients recover walking within 6 months following the vascular accident, the quality of walking is not satisfactory. This condition is related to foot spasticity, which evolves independently throughout recovery. Initially flaccid, it progresses to equinovarus, causing problems for standing, footwear, and walking, pain, claw toes, and calluses due to foot–shoe or foot–orthosis conflict. All these problems have been the subject of various studies for the management of spastic foot, but no consensus exists.
