• 대한족부족관절학회지
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• 제8권1호
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• pp.111-113
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• 2004

In neurogenic equinovarus deformity, surgical intervention such as tendon transfer or osteotomy can be expected to improve symptoms. However, in rare cases of hereditary spastic paraplegia, the deformity and paralysis gradually progress. So limited operation and early post-operative rehabilitation are preferred to aggressive operation. We would like to report our clinical experience with one case of hereditary spastic paraplegia patient with reference review. A 40 year-old male, given tendon transfer of ankle and foot and tendo achilles lengthening 10 years ago, complained about aggravated spastic paraplegia which resulted in dynamic equinovarus and limited walking ability since his operation. Family history showed limited walking ability of his father with gradually progressing spastic paralysis and he was diagnosed as hereditary spastic paraplegia type I. We had performed a limited operation such as tendo achilles and tibialis posterior lengthening to induce plantigrade standing and walking with crutch. As a result, the patient was able to maintain a stabilized standing posture and walk after the operation. Hereditary spastic paraplegia presents with a progressive paralysis which limits rehabilitation after tendon transfer, and the symptoms can be aggravated. Therefore, considering potential hereditary neurogenic disorders in paients with equinovarus deformity and performing limited operative procedures seem to be important.

• Annals of Clinical Neurophysiology
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• 제7권1호
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• pp.13-16
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• 2005

Background: The purpose of this study is to investigate the effect of the intensive functional electrical stimulation(FES) on the improvement of the gait pattern of the chronic hemiplegic patients. Method: Six hemiplegic patients, who could walk independently but have equinovarus deformity during the gait cycle, participated in this study. The affected peroneus longus and tibialis anterior muscles of all subjects were stimulated for 2 weeks period (20 minutes duration, 6 times/day). We measured the activities (mean voltage) of those muscles during the walking, using dynamic EMG. Results: After treatment, there were significant improvements in the strength of peroneus longus and tibialis anterior muscles and the gait speed, but there was no interval change of the spasticity of plantar flexor. The mean voltages of two muscles are significantly increased in all the patients (p<0.05). Conclusion: The results showed that the intensive FES on affected peroneus longus and tibialis anterior muscles in chronic hemiplegic patients could be useful for the improvement of functional gait.