International Recommendations to Manage Poststroke Equinovarus Foot Deformity Validated by a Panel of Experts Using Delphi

Autor: Marjorie Salga, Laure Gatin, Thierry Deltombe, Thierry Gustin, Stefano Carda, Philippe Marque, Paul Winston, Rajiv Reebye, Theodore Wein, Alberto Esquenazi, Mary-Ann Keenan, Franco Molteni, Paolo Zerbinati, Alessandro Picelli, Flavia Coroian, Bertrand Coulet, Nadine Sturbois-Nachef, Christian Fontaine, Alain Yelnik, Bernard Parratte, Prakash Henry, Srikant Venkatakrishnan, Philippe Rigoard, Romain David, Philippe Denormandie, Alexis Schnitzler, Etienne Allart, François Genet
Přispěvatelé: Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Toulouse Neuro Imaging Center (ToNIC), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI), Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Lille, UFR Médecine [Santé] - Université Paris Cité (UFR Médecine UPCité), Université Paris Cité (UPCité), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Lille Neurosciences & Cognition - U 1172 (LilNCog), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Abbott Laboratories, Roche, Medtronic, Biogen, AbbVie, Allergan, Boston Scientific Corporation, BSC, Ipsen, Supported by Allergan, an AbbVie company. The authors acknowledge Orpea-Clinea and Lagarrigue SA for providing funding to support the realization of the study., We thank Oscar Haigh for the English corrections. Supported by Allergan, an AbbVie company. The authors acknowledge Orpea-Clinea and Lagarrigue SA for providing funding to support the realization of the study. Disclosures: A.P. received unrelated funding from Allergan-Abbvie, Ipsen, and Merz. N.S.N. received unrelated funding from Ipsen. P.R. received unrelated funding from Abbott, Boston Scientific, Medtronic, Allergan-Abbvie, Ipsen, and Merz. S.C. received unrelated funding from Merz, Allergan-Abbvie, Ipsen, Almirall, Roche, Biogen, and Medtronic. T.D. received unrelated funding from Abbvie, IPSEN, and Merz. The other authors have no additional disclosures., UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de médecine physique et revalidation, UCL - (MGD) Service de neurochirurgie
Rok vydání: 2023
Předmět:
Zdroj: Archives of Physical Medicine and Rehabilitation
Archives of Physical Medicine and Rehabilitation, 2023, 104 (3), pp.372-379. ⟨10.1016/j.apmr.2022.07.020⟩
Archives of physical medicine and rehabilitation, Vol. 104, no. 3, p. 372-379 (2022)
ISSN: 0003-9993
Popis: International audience; Objective: To establish international recommendations for the management of spastic equinovarus foot deformity. Design: Delphi method. Setting: International study. Participants: A total of 24 international experts (N=24) in neuro-orthopedic deformities, from different specialties (Physical and Rehabilitation Medicine physicians, neurologists, geriatricians, orthopedic surgeons, neurosurgeons, plastic surgeons). Interventions: Experts answered 3 rounds of questions related to important aspects of diagnosis, assessment, and treatment of spastic equinovarus foot deformity. Main Outcome Measures: A consensus was established when at least 80% of experts agreed on a statement Results: A total of 52 items reached consensus. Experts recommend assessing effect of the deformity on functional activities before treatment. Before treatment, it is crucial to differentiate spastic muscle overactivity from soft tissue contractures, identify which muscles are involved in the deformity, and evaluate the activity of antagonist muscles. Motor nerve blocks, 2-dimensional video analysis, and radiologic examinations are often required to complement a clinical examination. The treatment of equinovarus foot depends on the correctability of the deformity and the patient's ability to stand or walk. The preoperative assessment should include an interdisciplinary consultation that must finalize a formal agreement between physicians and the patient, which will define personalized attainable goals before surgery. Conclusion: The establishment of guidelines on managing equinovarus foot will help physicians and surgeons, specialists, and nonspecialists to diagnoses and assess the deformity and direct patients to a network of experts to optimize patient functional recovery and improve their autonomy.
Databáze: OpenAIRE
Externí odkaz: