Rehabilitation interventions for foot drop in neuromuscular disease

Sackley, Catherine; Disler, Peter; Turner‐Stokes, Lynne; Wade, Derick T; Brittle, Nicola; Hoppitt, Thomas

doi:10.1002/14651858.cd003908.pub3

Cited by 62 publications

(53 citation statements)

References 28 publications

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“…A Cochrane Collaboration analysis of randomized trials of surgical, physical therapy, and orthotic interventions for foot drop in neuromuscular disorders found one study of CMT that met the review criteria. 5 In this study of 29 CMT subjects, a 24-week muscle strengthening and exercise program resulted in improvement in a 6-meter timed walk, with trends favoring the treatment in other outcomes including quality of life (QOL), and stair climbing. 5 A randomized, single-blind, cross-over study of nocturnal ankle splinting in CMT1A (n ϭ 14) showed no effect on ankle range of motion or strength.…”

Section: Review Of Current Treatment Options For Cmt and Past Therapementioning

confidence: 89%

“…5 In this study of 29 CMT subjects, a 24-week muscle strengthening and exercise program resulted in improvement in a 6-meter timed walk, with trends favoring the treatment in other outcomes including quality of life (QOL), and stair climbing. 5 A randomized, single-blind, cross-over study of nocturnal ankle splinting in CMT1A (n ϭ 14) showed no effect on ankle range of motion or strength. 6 Systematic studies on the effect of orthotics on gait and falls in CMT are relatively lacking, despite widespread use.…”

Section: Review Of Current Treatment Options For Cmt and Past Therapementioning

confidence: 89%

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Experimental Therapeutics in Hereditary Neuropathies: The Past, the Present, and the Future

Herrmann

2008

Neurotherapeutics

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Summary:Hereditary neuropathies represent approximately 40% of undiagnosed neuropathies in a tertiary clinic setting. The Charcot-Marie-Tooth neuropathies (CMT) are the most common. Mutations in more than 40 genes have been identified to date in CMT. Approximately 50% of CMT cases are accounted for by CMT type 1A, due to a duplication within the peripheral myelin protein 22 gene (PMP22). Mutations in the gap junction beta 1 gene (GJB1), the myelin protein zero gene (MPZ), and the mitofusin 2 gene (MFN2) account for a substantial proportion of other genetically definable CMT. Some 15% of demyelinating CMT and 70% of axonal CMT await genetic clarification. Other hereditary neuropathies include the hereditary sensory and autonomic neuropathies, the familial amyloid polyneuropathies, and multisystem disorders (e.g., lipid storage diseases and inherited ataxias) that have peripheral neuropathy as a major or minor component. This review surveys the challenges of developing effective therapies for hereditary neuropathies in terms of past, present, and future experimental therapeutics in CMT.

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Section: Review Of Current Treatment Options For Cmt and Past Therapementioning

confidence: 89%

Section: Review Of Current Treatment Options For Cmt and Past Therapementioning

confidence: 89%

Experimental Therapeutics in Hereditary Neuropathies: The Past, the Present, and the Future

Herrmann

2008

Neurotherapeutics

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“…Early surgery was very common in the past, but several studies showed to have a positive effect on Achilles tendon contractures only in the short-term, while long-term follow-up revealed recurrence of contractures in all patients who underwent intervention, demonstrating no functional benefit for the surgical approach alone [6].…”

Section: Discussionmentioning

confidence: 99%

“…Equinus deformity of the ankle is one of the serious orthopedic problems associated with DMD [5]. Te major cause of foot drop is the weakness of the muscles of ankle dorsiflexion, with a primary role supported by the deficiency of tibialis anterior, but also of the long extensors of the toes (extensor hallucis longus and extensor digitorum longus) [6]. A very important effect of this weakness is the shortening and contracture of the Achilles tendon.…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal Shock Waves in the Treatment of Equinovarus Foot in a Duchenne Patient: A Case Report

Barazzuol¹,

Lampropoulou²,

Meneghini³

et al. 2015

J Nov Physiother Phys Rehabil

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Background: Duchenne muscular dystrophy (DMD) is characterized by a progressive muscular weakness, with loss of independent ambulation. When the disease results in the complete loss of ambulation, one of the purposes of treatment during the latest phase is to prevent or reduce complications such as foot deformities.A 20-year-old DMD patient had a complete loss of muscular strength in the inferior and superior limbs and a severe bilateral clubfoot deformity. Active movements were not possible, while passive motion was very limited in dorsiflexion and pronation, inversion and eversion, with stronger limitation on the right foot.First, the patient was treated with gentle manipulation and casting for two weeks, but no improvement in passive range of motion was detected.The treatment was then modified by adding a session of focused extracorporeal shock wave therapy for five consecutive weeks. Results:After five shock wave sessions, both limbs showed a bilateral correction of the talometatarsal angle, respectively 26° on the right and 19° on the left foot. The most relevant improvements were estimated in the passive dorsiflexion of both ankles: with a gentle manipulation, both feet could return to the anatomical position, in such a way to allow the patient to wear his own shoes. Conclusions:There is increasing evidence that nitric oxide (NO) and vascular endothelial growth factor (VEGF) dysregulation is involved in DMD progression; on the other hand, extracorporeal shock wave therapy (ESWT) induces NO and VEGF production, thus promoting angiogenesis, and has proven effective in reducing muscular hypertone. ESWT shows a potential role in the treatment of Duchenne complications such as foot deformities, as part of a multidisciplinary rehabilitation program.of their antagonist muscle tendons 6 . When ambulation is no longer possible, the rehabilitation program focuses on the prevention or reduction of complications and deformities, in order to alleviate pain and pressure, to allow the patient to wear shoes, and to correctly place the feet on wheelchair footrests [7].Despite the absence of a specific treatment, the natural history of the DMD can be in part modified [1].Since the surgical therapy showed controversial results on long term effectiveness, there has been a growing consideration on the conservative approach, including drugs and rehabilitation. Nevertheless, in most studies the rehabilitation programme includes stretching, eccentric and aerobic exercise, sub maximum strengthening activity when residual strength is higher, while few authors emphasize the role of physical energies, like whole-body vibration [8,9] and laser therapy [10].Extracorporeal shock wave therapy (ESWT) is a relatively recent method used in the treatment of many musculoskeletal disorders, such as tendinopathies and non-union fractures.Over the past few years, ESWT has received a widespread consensus in many other fields, including in the treatment of spastic hypertone in patients affected by stroke: even a single session of shock

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“…Стрейч-терапия как компонент комплексной фи-зической абилитации широко используется у пациен-тов со многими нервно-мышечными заболеваниями, в том числе и при БШМТ, и является одним из методов программы физической терапии [12][13][14][15]. Стрейч-те-рапия показана при любой стадии БШМТ, как у взро-слых, так и у детей [15][16][17].…”

Section: характеристика исследованийunclassified

Role of stretch therapy in comprehensive physical habilitation of patients with Charcot–Marie–Tooth hereditary neuropathy

Шнайдер¹,

Goncharova²

2015

Neuromuscular Diseases

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1'2015 Нервно-мышечные Б О Л Е З Н И 37 Оригинальные исследованияВведение Болезнь Шарко-Мари-Тута (БШМТ) -наибо-лее распространенная форма наследственных не-вропатий, сопровождающаяся чувствительными нарушениями, прогрессирующей мышечной слабо-стью с формированием инвалидизирующих кон-трактур конечностей. Развитие контрактур является общим симптомом многих нервно-мышечных забо-леваний, в том числе и БШМТ [1][2][3][4]. Клинические проявления БШМТ различаются большим поли-морфизмом даже в пределах одной семьи [5]. Ско-рость прогрессирования заболевания широко варь-ирует: в одних случаях состояние стабильное в течение нескольких десятилетий, в других -про-грессирование заболевания довольно быстрое. Основная цель лечения пациентов с БШМТ -за-медление естественных процессов болезни и улуч-шение качества жизни и трудоспособности пациен-тов [6][7][8][9]. В настоящее время основным методом лечения БШМТ является программа эффективной абилитации, которая может предотвратить развитие деформаций конечностей и тем самым улучшить качество жизни пациента.Цель исследования -проведение критического обзора литературы на основе поиска всех доступных русскоязычных и англоязычных исследований по из-учению использования стрейч-терапии при БШМТ с конкретными задачами: 1) выявление любых методик стрейч-терапии, разработанных для лечения и абили-тации пациентов с БШМТ; 2) оценка эффективности применения стрейч-терапии как отдельного метода абилитации при БШМТ, так и в сочетании с другими методами (ночное шинирование, силовая и аэробная тренировка и др.

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Rehabilitation interventions for foot drop in neuromuscular disease

Cited by 62 publications

References 28 publications

Experimental Therapeutics in Hereditary Neuropathies: The Past, the Present, and the Future

Experimental Therapeutics in Hereditary Neuropathies: The Past, the Present, and the Future

Extracorporeal Shock Waves in the Treatment of Equinovarus Foot in a Duchenne Patient: A Case Report

Role of stretch therapy in comprehensive physical habilitation of patients with Charcot–Marie–Tooth hereditary neuropathy

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