Evaluation of serial casting to correct equinovarus deformity of the ankle after acquired brain injury in adults.

Objective: To examine an adult population undergoing rehabilitation after brain injury to determine the incidence of ankle contracture and factors contributing to the development of this deformity. Design: Descriptive study Setting Specialist in patient neurosurgical rehabilitation unit in Australia...

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Main Authors: Singer, B., Gnanaletchumy, J., Singer, K., Allison, Garry
Format: Journal Article
Published: Elsevier 2003
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/3682
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author Singer, B.
Gnanaletchumy, J.
Singer, K.
Allison, Garry
author_facet Singer, B.
Gnanaletchumy, J.
Singer, K.
Allison, Garry
author_sort Singer, B.
building Curtin Institutional Repository
collection Online Access
description Objective: To examine an adult population undergoing rehabilitation after brain injury to determine the incidence of ankle contracture and factors contributing to the development of this deformity. Design: Descriptive study Setting Specialist in patient neurosurgical rehabilitation unit in Australia. Participants Patients (N=105) admitted with a new diagnosis of moderate to severe brain injury over a 12-month period. Main outcome measures: Maximal ankle dorsiflexion range and the presence of abnormal muscle tone affecting the lower limb(s) were evaluated at weekly intervals. Ankle contracture was defined as maximal passive range of less than 0 dorsiflexion with the knee in extension. Patients were grouped into 3 muscle tone categories: normal, predominantly spastic, or predominantly dystonic. Age, sex, mechanism and severity of brain injury, time to onset of ankle contracture, total length of hospital stay, and discharge mobility status data were also recorded. Results: Muscle tone was designated as normal in 68 (64.7%), as spastic in 14 (13.3%), and as dystonic in 23 (21.9%) patients. The incidence of ankle contracture was 16.2% (17/105 cases). Ankle deformity correlated closely with muscle tone category. Of 23 cases with dystonic muscle overactivity, 17 developed contracture at some point between 1 and 16 weeks after brain injury, although no subject with normal tone or spasticity developed the deformity. There was a weak association between the severity of brain injury and development of ankle contracture. Conclusions: The incidence of ankle contracture was much lower than previously reported. Dystonic overactivity of the plantarflexor and invertor muscles is a major predisposing factor to ankle contracture.
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spelling curtin-20.500.11937-36822017-09-13T16:06:09Z Evaluation of serial casting to correct equinovarus deformity of the ankle after acquired brain injury in adults. Singer, B. Gnanaletchumy, J. Singer, K. Allison, Garry Rehabilitation Contracture Risk factors Brain injuries Incidence Dystonia Ankle Muscle spasticity Objective: To examine an adult population undergoing rehabilitation after brain injury to determine the incidence of ankle contracture and factors contributing to the development of this deformity. Design: Descriptive study Setting Specialist in patient neurosurgical rehabilitation unit in Australia. Participants Patients (N=105) admitted with a new diagnosis of moderate to severe brain injury over a 12-month period. Main outcome measures: Maximal ankle dorsiflexion range and the presence of abnormal muscle tone affecting the lower limb(s) were evaluated at weekly intervals. Ankle contracture was defined as maximal passive range of less than 0 dorsiflexion with the knee in extension. Patients were grouped into 3 muscle tone categories: normal, predominantly spastic, or predominantly dystonic. Age, sex, mechanism and severity of brain injury, time to onset of ankle contracture, total length of hospital stay, and discharge mobility status data were also recorded. Results: Muscle tone was designated as normal in 68 (64.7%), as spastic in 14 (13.3%), and as dystonic in 23 (21.9%) patients. The incidence of ankle contracture was 16.2% (17/105 cases). Ankle deformity correlated closely with muscle tone category. Of 23 cases with dystonic muscle overactivity, 17 developed contracture at some point between 1 and 16 weeks after brain injury, although no subject with normal tone or spasticity developed the deformity. There was a weak association between the severity of brain injury and development of ankle contracture. Conclusions: The incidence of ankle contracture was much lower than previously reported. Dystonic overactivity of the plantarflexor and invertor muscles is a major predisposing factor to ankle contracture. 2003 Journal Article http://hdl.handle.net/20.500.11937/3682 10.1053/apmr.2003.50041 Elsevier restricted
spellingShingle Rehabilitation
Contracture
Risk factors
Brain injuries
Incidence
Dystonia
Ankle
Muscle spasticity
Singer, B.
Gnanaletchumy, J.
Singer, K.
Allison, Garry
Evaluation of serial casting to correct equinovarus deformity of the ankle after acquired brain injury in adults.
title Evaluation of serial casting to correct equinovarus deformity of the ankle after acquired brain injury in adults.
title_full Evaluation of serial casting to correct equinovarus deformity of the ankle after acquired brain injury in adults.
title_fullStr Evaluation of serial casting to correct equinovarus deformity of the ankle after acquired brain injury in adults.
title_full_unstemmed Evaluation of serial casting to correct equinovarus deformity of the ankle after acquired brain injury in adults.
title_short Evaluation of serial casting to correct equinovarus deformity of the ankle after acquired brain injury in adults.
title_sort evaluation of serial casting to correct equinovarus deformity of the ankle after acquired brain injury in adults.
topic Rehabilitation
Contracture
Risk factors
Brain injuries
Incidence
Dystonia
Ankle
Muscle spasticity
url http://hdl.handle.net/20.500.11937/3682