Comparison between tibial nerve block with anaesthetics and neurotomy in hemiplegic adults with spastic equinovarus foot.

Abstract

OBJECTIVE:

The aim of the study was to compare the effect of diagnostic motor nerve block with anaesthetics and of selective tibial neurotomy in the treatment of spastic equinovarus foot in hemiplegic adults.

METHODS:

In this prospective observational study, 30 hemiplegic adults with spastic equinovarus foot benefited from a diagnostic nerve block with anaesthetics followed by a selective tibial neurotomy performed at the level of the same motor nerve branches of the tibial nerve. Spasticity (Ashworth scale), muscle strength (Medical Research Council scale), passive ankle dorsiflexion (ROM), gait parameters (10 meters walking test) and gait kinematics (video assessment) were assessed before and after the nerve block and two months and two years after selective tibial neurotomy.

RESULTS:

The decrease in spasticity and the improvement in gait kinematics were similar after the diagnostic nerve block and two months and two years after neurotomy. The diagnostic nerve block did not revealed the slight increase in gait speed and in tibialis anterior muscle strength that was observed two years after neurotomy.

CONCLUSION:

This study suggests that diagnostic nerve block with anaesthetics and selective neurotomy equally reduce spasticity and improve gait in case of spastic equinovarus foot in hemiplegic adults. Diagnostic nerve block can be used as a valuable screening tool before neurotomy.

• Authors: Thierry Deltombe, Corinne Bleyenheuft, Thierry Gustin
• Journal: Annals of physical and rehabilitation medicine (Ann Phys Rehabil Med) Vol. 58 Issue 2 Pg. 54-9 (Apr 2015) ISSN: 1877-0665 [Electronic] Netherlands
• PMID: 25614022 (Publication Type: Comparative Study, Journal Article, Observational Study)
• Copyright: Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Chemical References

• Anesthetics

Topics

• Adult
• Aged
• Anesthetics (therapeutic use)
• Biomechanical Phenomena
• Clubfoot (etiology, physiopathology, surgery)
• Denervation (methods)
• Female
• Follow-Up Studies
• Gait (physiology)
• Hemiplegia (complications, physiopathology)
• Humans
• Male
• Middle Aged
• Muscle Spasticity (etiology, physiopathology, surgery)
• Muscle Strength
• Muscle, Skeletal (innervation, physiopathology)
• Nerve Block (methods)
• Prospective Studies
• Tibial Nerve (surgery)
• Young Adult