[Epidemiology of pes varus and/or equinus one year after a first cerebral hemisphere stroke: apropos of a cohort of 86 patients].
OBJECTIVE
To determine the frequency and the functional consequences of varus equinus in stabilized vascular hemiplegia.


METHODS
Prospective cohort study of 86 hemiplegic patients. All patients consecutively admitted for a first hemispheral stroke between July 2001 and January 2002 were included. The evaluation consisted in a clinical examination and a descriptive study of gait. The functional capacity of patients with and without varus equinus were compared using the Barthel index, the New Functional Ambulation Classification (NFAC), the confortable ten meters gait speed and gait perimeter.


RESULTS
The incidence of varus equinus was 18%. There was no difference in gait speed (0.8 m/s), NFAC or Barthel index between patients with or without varus equinus. Patients with varus equinus had had more specialized, intensive and prolonged rehabilitation. The only prognostic factor that could be identified was the motor impairment and the existence of spasticity.


CONCLUSIONS
The mechanism of varus equinus is thought to be mainly the over-activity of gastrocnemius and solaris compared to that of the tibialis anterior, associated to the weakness of fibular muscles. The role of tibialis posterior is thought to be less important. The frequency of varus equinus after a first hemispheral stroke was low and the consequences were limited. This could be in part explained by the access of these patients to early, specialized and prolonged rehabilitation care.
Verdié
C
C
Département de médecine physique et de réadaptation, hôpital Jean-Rebeyrol, CHU Dupuytren, 87042 Limoges, France.
Daviet
J C
JC
Borie
M J
MJ
Popielarz
S
S
Munoz
M
M
Salle
J Y
JY
Rebeyrotte
I
I
Dudognon
P
P
D000368:Aged; D019090:Case Management; D015331:Cohort Studies; D004863:Equinus Deformity / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D020233:Gait Disorders, Neurologic / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006429:Hemiplegia / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000453:epidemiology / Q000209:etiology; D018482:Muscle, Skeletal / Q000503:physiopathology; D011446:Prospective Studies; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D000071939:Stroke Rehabilitation