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Foot drop splints improve proximal as well as distal leg control during gait in Charcot-Marie-Tooth Disease

Authors

  • Gita M. Ramdharry MSc, PhD,

    1. School of Rehabilitation Sciences, St George's University of London and Kingston University, Cranmer Terrace, SW17 ORE United Kingdom
    2. MRC Center for Neuromuscular Diseases, Department of Molecular Pathogenesis, UCL Institute of Neurology, Queen Square, London WC1N 3BG United Kingdom
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  • Brian L. Day MSc, DPhil,

    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square WCIN 3BG United Kingdom
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  • Mary M. Reilly MD, FRCP,

    1. MRC Center for Neuromuscular Diseases, Department of Molecular Pathogenesis, UCL Institute of Neurology, Queen Square, London WC1N 3BG United Kingdom
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  • Jonathan F. Marsden MSc, PhD

    Corresponding author
    1. School of Health Professions, University of Plymouth, Derriford Road PL6 8BH United Kingdom
    • School of Health Professions, University of Plymouth, Derriford Road PL6 8BH United Kingdom
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Abstract

Introduction: During walking, people with Charcot-Marie-Tooth (CMT) disease may compensate for distal weakness by using proximal muscles. We investigated the effect of different AFOs on distal leg control and proximal compensatory actions. Methods: Fourteen people with CMT were tested while wearing 3 types of ankle-foot orthosis (AFO) bilaterally compared with shoes alone. Walking was assessed using three-dimensional gait analysis. Stiffness of the splints was measured by applying controlled 5-degree ankle stretches using a motor. Results: The results showed that each AFO significantly stiffened the ankle and increased ankle dorsiflexion at foot clearance compared with shoes alone. At push off, peak ankle power generation was reduced, but only with 1 type of AFO. A significant decrease in hip flexion amplitude during the swing phase was observed with all 3 AFOs. Conclusions: These results indicate that AFOs reduce foot drop and remove the need for some proximal compensatory action. Muscle Nerve 46: 512–519, 2012

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