title: Use of a static adjustable ankle-foot orthosis following tibial nerve block to reduce plantar-flexion contracture in an individual with brain injury.
abstract: OBJECTIVE
  Ankle plantar-flexion contractures are a common complication of brain injuries and can lead to secondary limitations in mobility.
  
  
  METHODS
  The patient was a 44-year-old woman with left hemiplegia following a right frontal arteriovenous malformation resection. She had a left ankle plantar-flexion contracture of -31 degrees from neutral. After a tibial nerve block, an adjustable ankle-foot orthosis was applied 23 hours a day for 27 days. Adjustments of the orthosis were made as the contracture was reduced. The patient received physical therapy during the 27-day period for functional mobility activities and stretching the plantar flexors outside of the orthosis.
  
  
  RESULTS
  The patient's dorsiflexion passive range of motion increased from -31 degrees to +10 degrees.
  
  
  CONCLUSIONS
  The application of an adjustable ankle-foot orthosis following a tibial nerve block, as an addition to a physical therapy regimen of stretching and mobility training, may reduce plantar-flexion contractures in patients with brain injury.
authors.affiliation: EXCITE National Clinical Trial, Emory Center for Rehabilitation Medicine, Room 206, 1441 Clifton Rd, Atlanta, GA 30322, USA. Sarah_Blanton@emoryhealthcare.org
authors.forename: Sarah
authors.initials: S
authors.lastname: Blanton
authors.forename: Samuel P
authors.initials: SP
authors.lastname: Grissom
authors.forename: Lisa
authors.initials: L
authors.lastname: Riolo
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology*; D003286:Contracture / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D006429:Hemiplegia / Q000150:complications* / Q000209:etiology; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000601:surgery*; D009407:Nerve Block; D009989:Orthotic Devices; D026741:Physical Therapy Modalities / Q000379:methods*; D016059:Range of Motion, Articular; D018709:Statistics, Nonparametric; D013979:Tibial Nerve / Q000503:physiopathology*; D013997:Time Factors