Definition
It is an abnormal
neuromuscular disorder that affects the patient’s ability to raise their foot
at the ankle.
Due to paralysis
of the ankle dorsiflexors (tibialis anterior) the planterflexors overact causing the toes to go and first
contact the ground, so to avoid this patient flex his hip and raise foot and
slap on the floor forcibly.
Gait analysis
Due to paralysis of dorsiflexors: patient cannot use dorsiflexors to attain normal neutral
position of the ankle, which is necessary to complete the task of clearing the
foot during swing phase.To
compensate for inability to dorsiflex the ankle by increasing the hip and knee
flex above normal amount by circumduction of the entire hip or hip hiking.
- Associated condition : GBS / Polio / Spinal disc herniation / peroneal muscle or
nerve injury / stroke
PT management
For early cases: conservative treatment can be adopted, put patient on L – splint
/ bandage.
Then followed by active or passive physiotherapy: Training
should be first on the even surface and then on uneven surface
-
- Ankle exercise to strength anterior tibialis
- Strengthening of calf muscle can ensure that ankle ROM is well maintained
- Neuromuscular electrical stimulation help in contracting muscle to have a movement and function properly
- Stretching of the contracted muscle
- Back strengthening exercise, if there is weakness of the anterior tibialis caused by sciatica compression
- Gait training by parallel bar walking using a mirror as a biofeedback
- Assistive device like AFO (Ankle Foot Orthosis).
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