Foot drop and plantar flexion failure determine different gait strategies in Charcot-Marie-Tooth patients.
OBJECTIVE
To describe the temporal, kinetic, kinematic, electromyographic and energetic aspects of gait in Charcot-Marie-Tooth patients with foot drop and plantar flexion failure.


METHODS
A sample of 21 patients fulfilling clinical, electrodiagnostic and genetic criteria for Charcot-Marie-Tooth disease were evaluated by computerized gait analysis system and compared to a group of matched healthy subjects. Patients were classified as having isolate foot drop (group 1) and association of foot drop and plantar flexion failure (group 2).


RESULTS
While it was impossible to detect a reliable gait pattern when the group of patients was considered as a whole and compared to healthy subjects, we observed two distinctive gait patterns when patients were subdivided as group 1 or 2. Group 1 showed a gait pattern with some characteristics of the "steppage pattern". The complex motor strategy adopted by this group leads to reduce the swing velocity and to preserve the step length in spite of a high energy consumption. Group 2 displayed a "clumsy pattern" characterized by very slow gait with reduced step length, a broader support area and great reduction in the cadence. This group of patients is characterized by a low energy consumption and greater energy recovery, due above all to the primary deficit and the various compensatory mechanisms.


CONCLUSIONS
Such between-group differences in gait pattern can be related to both primary motor deficits and secondary compensatory mechanisms. Foot drop and plantar flexion failure affect the overall gait strategy in Charcot-Marie-Tooth patients.
Don
Romildo
R
Department of Physical Medicine and Rehabilitation, Movement Analysis Laboratory, La Sapienza University of Rome, Italy. romildodon@inwind.it
Serrao
Mariano
M
Vinci
Paolo
P
Ranavolo
Alberto
A
Cacchio
Angelo
A
Ioppolo
Francesco
F
Paoloni
Marco
M
Procaccianti
Rita
R
Frascarelli
Flaminia
F
De Santis
Fabio
F
Pierelli
Francesco
F
Frascarelli
Massimo
M
Santilli
Valter
V
D000293:Adolescent; D000328:Adult; D002607:Charcot-Marie-Tooth Disease / Q000503:physiopathology*; D005260:Female; D005528:Foot / Q000503:physiopathology*; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*