Prevalence and classification of equinus foot in bilateral spastic cerebral palsy

Horsch, Axel; Götze, Marco; Geisbüsch, Andreas; Beckmann, Nicholas A.; Tsitlakidis, Stefanos; Berrsché, Gregor; Klotz, Matthias

doi:10.1007/s12519-019-00238-2

Cited by 26 publications

(34 citation statements)

References 20 publications

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“…According to the type of equinus foot, 3 studies reported patients with dynamic equinus, one study reported patients with fixed equinus, and 18 studies did not report the type of equinus foot. The mean age of patients with CP ranged from 3.8 (SD = 2) years [ 17 ] to 18.2 (SD = 9.9) years [ 6 ]. Based on gender, male patients with CP ranged from 33% [ 24 ] to 75% of the studied population [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…Certain designs had only one study, and therefore, they were not reliable in estimating the overall prevalence rate of equinus foot in CP. Meanwhile, 14 studies were cohort in design, and they had an overall prevalence rate of 62% (95% CI: 47–74%; I 2 = 98%, p < 0.01) [ 6 , 17 , 20 , 24 , 25 , 27 , 28 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. On the other hand, 4 studies were case series in design, with an overall prevalence rate of 92% (95% CI: 34–100%; I 2 = 84%, p < 0.01) [ 18 , 19 , 21 , 29 ].…”

Section: Prevalence Of Equinus Footmentioning

confidence: 99%

“…In some studies, equinus foot is defined as inability of foot/ankle dorsiflexion above plantigrade, with the hindfoot in a neutral position, while the knee is extended [ 4 , 5 ]. In other studies, equinus foot is defined as ≤5° of ankle dorsiflexion while the knee is extended [ 6 ] or when the degree of ankle dorsiflexion during the stance phase of gait is >1 standard deviation (SD) less than the average reference value [ 7 ]. Moreover, in a previous consensus workshop, equinus foot was defined as the presence of a functional gait or standing pattern that is characterized by unequal weight bearing on the metatarsal heads, along with increased plantarflexion at the ankle [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Is the Prevalence of Equinus Foot in Cerebral Palsy Overestimated? Results from a Meta-Analysis of 4814 Feet

Horsch

Klotz²,

Platzer

et al. 2021

JCM

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Background: Equinus is a common foot deformity in patients with cerebral palsy (CP). However, its prevalence is scarcely reported in the literature. Therefore, we conducted this review to estimate the prevalence of equinus foot in CP. Methods: Eight databases were searched. Our primary outcome was the prevalence of equinus foot in CP patients. Subgroup analysis was conducted based on study design, the laterality of CP, and whether equinus foot was defined or not. Results: The prevalence of equinus foot in CP was 93% (95% CI: 71–99). The prevalence was 99% (95% CI: 55–100), 96% (95% CI: 57–100), and 65% (95% CI: 37–86) in unilateral, both, and bilateral CP, respectively. Based on study design, equinus foot prevalence was 92% (95% CI: 34–100) in case series and 62% (95% CI: 47–74) in cohort studies. Four studies reported definition criteria for equinus foot, with a pooled prevalence rate of equinus foot of 99% (95% CI: 36–100) compared to a rate of 89% (95% CI: 59–98) among studies that lacked a definition criterion. Conclusions: This is the first meta-analysis to address the prevalence of equinus foot in CP patients. Although its prevalence is very high, our findings should be interpreted with caution due to the presence of multiple limitations, such as the lack of standardized definition criteria for equinus foot, the inappropriate study design, the wide confidence interval of equinus foot rate, and the small number of studies investigating it as a primary outcome.

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Section: Resultsmentioning

confidence: 99%

Section: Prevalence Of Equinus Footmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is the Prevalence of Equinus Foot in Cerebral Palsy Overestimated? Results from a Meta-Analysis of 4814 Feet

Horsch

Klotz²,

Platzer

et al. 2021

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

“…In the current study, R1 and R2 values were measured using a goniometer. The Silfverskiold test was used in some studies to differentiate the gastrocnemius and soleus muscles in children with CP (27,28). In the supine position, ankle dorsiflexion range was measured using a goniometer with the knee and hip fully extended on the tested side and passively in 90° flexion.…”

Section: Assessmentmentioning

confidence: 99%

Acute Effects of Intramuscular Stretching and Passive Stretching on Spasticity in Children With Cerebral Palsy

Akkaya

Elbasan

2021

Türk Fizyoterapi Ve Rehabilitasyon Dergisi

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Purpose: Several methods are used to reduce spasticity in cerebral palsy (CP) rehabilitation. One of these methods is stretching. This study aimed to compare the acute effects of intramuscular stretching and passive stretching on spasticity in children with bilateral spastic CP. Methods:The study included a total of 22 children (12 boys and 10 girls) with bilateral CP, between the ages of 5 and 13 years (mean age=6.45±1.96 years), who had spasticity in the plantar flexor muscle groups. All children were under an individualized physiotherapy program. In addition to the physiotherapy program, intramuscular stretching was applied to the plantar flexor muscles on one side, whereas passive manual stretching was applied to the other side. The Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS), and Silfverskiold test were used to assess the spasticity. Evaluations were performed before and after the applications.Results: There was a significant difference between pre and post-treatment comparisons in the intramuscular stretching side (MAS p=0.024, MTS R2-R1 p<0.001, Silfverskiold test p=0.002) and the passive stretching side (MAS p=0.014, MTS R2-R1 p=0.001, and the Silfverskiold test p=0.003). On the other hand, there was no difference between the intramuscular and passive stretching sides (p>0.05). Conclusion:Both intramuscular and passive stretching are effective methods for reducing spasticity in children with bilateral spastic CP, and their acute effects are similar.

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“…Talipes equinovarus, talipes valgus, high-arched foot, and tibial rotation are the most common malformations in patients with spastic CP. Talipes valgus is the most common global deformity of deformed feet in spastic CP, which consists of foot-drop deformity and hindfoot inversion [159, 160]. The important cause of this is insufficient muscle strength or muscle contracture, while another reason is excessive muscle strength of the tibialis anterior muscle.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Orthopedic treatment of the lower limbs in spastic paralysis

Deng

Zeng

et al. 2020

Brain Science Advances

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Spastic paralysis of the limb mainly results from the central lesion, in which spastic cerebral palsy is the common cause. Due to durative muscle spasm in spastic cerebral palsy, it is often accompanied by the formation of secondary musculoskeletal deformities, resulting in limb motor disability. Based on its pathogenesis, surgical treatment is currently applied: selective posterior rhizotomy (SPR) or orthopedic surgery. The primary purpose of early orthopedic surgery was simply to correct limb deformities, which usually led to the recurrence of deformity as a result of the presence of spasticity. With the application of SPR, high muscle tone was successfully relieved, but limb deformity was still present postoperatively. Therefore, this study aimed to elaborate on the management of orthopedic surgery, common deformities of the lower limb, and orthopedic operative methods; discuss the relationship between SPR and orthopedic procedure for limb deformity; and focus on the indications, timing of intervention, and postoperative outcome of different surgical methods.

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Prevalence and classification of equinus foot in bilateral spastic cerebral palsy

Cited by 26 publications

References 20 publications

Is the Prevalence of Equinus Foot in Cerebral Palsy Overestimated? Results from a Meta-Analysis of 4814 Feet

Is the Prevalence of Equinus Foot in Cerebral Palsy Overestimated? Results from a Meta-Analysis of 4814 Feet

Acute Effects of Intramuscular Stretching and Passive Stretching on Spasticity in Children With Cerebral Palsy

Orthopedic treatment of the lower limbs in spastic paralysis

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