Use of a static adjustable ankle-foot orthosis following tibial nerve block to reduce plantar-flexion contracture in an individual with brain injury.
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.
Blanton
Sarah
S
EXCITE National Clinical Trial, Emory Center for Rehabilitation Medicine, Room 206, 1441 Clifton Rd, Atlanta, GA 30322, USA. Sarah_Blanton@emoryhealthcare.org
Grissom
Samuel P
SP
Riolo
Lisa
L
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