Foot drop and plantar flexion failure determine different gait strategies in CMT

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Clin Biomech (Bristol, Avon). 2007 Aug 6

Foot drop and plantar flexion failure determine different gait

strategies in Charcot-Marie-Tooth patients.

Don R, Serrao M, Vinci P, Ranavolo A, Cacchio A, Ioppolo F, Paoloni

M, Procaccianti R, Frascarelli F, De Santis F, Pierelli F,

Frascarelli M, Santilli V.

Department of Physical Medicine and Rehabilitation, Movement

Analysis Laboratory, " La Sapienza " University of Rome, Italy.

OBJECTIVE: To describe the temporal, kinetic, kinematic,

electromyographic and energetic aspects of gait in Charcot-Marie-

Tooth patients with foot drop and plantar flexion failure.

METHODS: A sample of 21 patients fulfilling clinical,

electrodiagnostic and genetic criteria for Charcot-Marie-Tooth

disease were evaluated by computerized gait analysis system and

compared to a group of matched healthy subjects. Patients were

classified as having isolate foot drop (group 1) and association of

foot drop and plantar flexion failure (group 2).

RESULTS: While it was impossible to detect a reliable gait pattern

when the group of patients was considered as a whole and compared to

healthy subjects, we observed two distinctive gait patterns when

patients were subdivided as group 1 or 2. Group 1 showed a gait

pattern with some characteristics of the " steppage pattern " . The

complex motor strategy adopted by this group leads to reduce the

swing velocity and to preserve the step length in spite of a high

energy consumption.

Group 2 displayed a " clumsy pattern " characterized by very slow gait

with reduced step length, a broader support area and great reduction

in the cadence. This group of patients is characterized by a low

energy consumption and greater energy recovery, due above all to the

primary deficit and the various compensatory mechanisms.

CONCLUSIONS: Such between-group differences in gait pattern can be

related to both primary motor deficits and secondary compensatory

mechanisms. Foot drop and plantar flexion failure affect the overall

gait strategy in Charcot-Marie-Tooth patients.

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http://www.clinbiomech.com/article/S0268-0033(07)00125-8/pdf

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