title: Orthotic fitting improves gait in a patient with generalized secondary dystonia.
abstract: OBJECTIVE
  To determine whether an orthotic fitting improved gait in an adult patient presenting with generalized secondary dystonia.
  
  
  METHODS
  The patient had stance and gait disturbances associated with pain, ankle instability and fatigability. Clinical examination showed the presence of dystonia in the foot and ankle, along with equinovarus foot, mainly on the left side. The patient was fitted with a patellar tendon-bearing orthosis on the left side, orthopaedic shoes and plantar orthoses.
  
  
  METHODS
  The outcome of the treatment after 12 months was assessed on the basis of a physical examination and an instrumental gait assessment, using the GAITRite(R) system to analyse spatiotemporal parameters and force-plates to measure body weight distribution.
  
  
  RESULTS
  The fitting resulted in a significant improvement in gait, reduced pain and ankle instability, decreased cadence, increased step length and single foot support time, and reduced asymmetry of the temporo-spatial patterns and body weight distribution.
  
  
  CONCLUSIONS
  Patellar tendon-bearing orthoses and orthopaedic shoes could provide a good therapeutic approach for improving gait in patients with generalized secondary dystonia.
authors.affiliation: Unit of Physical and Rehabilitation Medicine. General Hospital,Roanne.
authors.forename: Serge
authors.initials: S
authors.lastname: Mirlicourtois
authors.forename: Laurent
authors.initials: L
authors.lastname: Bensoussan
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Viton
authors.forename: Hervé
authors.initials: H
authors.lastname: Collado
authors.forename: Tatiana
authors.initials: T
authors.lastname: Witjas
authors.forename: Alain
authors.initials: A
authors.lastname: Delarque
mesh_terms: D000328:Adult; D020821:Dystonic Disorders / Q000503:physiopathology / Q000534:rehabilitation*; D005684:Gait / Q000502:physiology; D006801:Humans; D007593:Joint Instability / Q000628:therapy; D008297:Male; D009989:Orthotic Devices / Q000592:standards; D059408:Pain Management; D013997:Time Factors; D016896:Treatment Outcome