Gait changes after tendon functional surgery for equinovarus foot in patients with stroke: assessment of temporo-spatial, kinetic, and kinematic parameters in 177 patients.

OBJECTIVE

In patients with hemiplegic stroke, equinovarus foot is one of the most frequent deformities. Outcome evidence for surgical correction of equinovarus foot is scarce, and results are usually assessed only clinically. Moreover, concerns about possible loss of function after elongation of the plantar flexor muscles are still at issue. The objective of this study was to verify if surgical correction of equinovarus foot can improve gait speed and function.

DESIGN

We used a retrospective, nonrandomized design. One hundred seventy-seven chronic hemiplegic patients who underwent surgical correction of equinovarus foot were evaluated before and 1 yr after surgery. Outcome measures were walking handicap score, temporal-spatial parameters, gait kinematics and kinetics, and paretic propulsion.

RESULTS

After surgery, walking handicap and temporal-spatial parameters significantly improved, as did ankle kinematic data and gait kinetic data. Patients' gait at follow-up was faster, with a more normal base of support and with better foot advancement. Paretic propulsion increased significantly after surgery, even if ankle power at push-off was reduced. We also observed a low complication rate.

CONCLUSIONS

Surgical correction of equinovarus foot deformity in patients with stroke is a safe and effective procedure. Even if the power generation at the ankle decreased, overall gait function and parameters improved after surgery.