■患有Charcot-Marie-Tooth病(CMT)的患者通常患有与行走有关的疼痛(WRP),肌肉无力,足部畸形,和减少踝关节背屈(DF),这会影响他们的行走能力和日常活动。功能性手术(FS)可以恢复足部偏差,影响步态过程中的加载能力。我们评估了CMT患者FS对WRP的短期影响,脚和脚踝结构,和功能,随着患者感知到的改善。
■这是一项针对接受FS和康复的CMT患者的前瞻性队列研究。我们分析了1个月后的变化,专注于WRP,DF,步行过程中的压力进展中心(COPP),和步行能力的测量。使用非参数Wilcoxon检验。
■包括10名患者。FS后一个月,WRP从5.5(IQR=3.5)降低到2(IQR=3.5),p=0.063,效果大小为0.615。在手术前疼痛水平非常高的患者中发现下降幅度最高。主动和被动运动的DF几乎达到10°(p<0.05),COPP从44%提高到60%(p=0.009)的脚长。步态速度,下肢功能,平衡没有改变。超过一半的样品在FS后感觉改善或改善很多。
■FS可在短期内有效减少CMT患者的WRP和恢复足部姿势,允许他们穿鞋,并带来感知的改善和满意度。功能技能缺乏改善可能是由于CMT典型的肌肉无力。随访时间较长的研究可能会证实这些假设。
UNASSIGNED: Patients with Charcot-Marie-Tooth disease (CMT) often suffer from walking-related pain (WRP), muscle weakness, foot deformities, and reduced ankle dorsiflexion (DF), which affects their ability to walk and daily activities. Functional surgery (FS) can restore foot deviations, affecting the loading ability during gait. We assessed the short-term effects of FS in patients with CMT on WRP, foot and ankle structure, and function, along with patients\' perceived improvement.
UNASSIGNED: This is a prospective cohort
study on CMT patients who had undergone FS and rehabilitation. We analyzed the changes after 1 month, focusing on WRP, DF, the center of pressure progression (COPP) during walking, and measures of walking ability. The non-parametric Wilcoxon test was used.
UNASSIGNED: Ten patients were included. One month after FS, WRP reduced from 5.5 (IQR = 3.5) to 2 (IQR = 3.5), p = 0.063, with an effect size of 0.615. The highest decrease was found in patients with very high pre-surgical pain levels. DF almost reached 10° for both active and passive movements (p < 0.05), and COPP improved from 44 to 60% (p = 0.009) of foot length. Gait speed, lower limb functioning, and balance did not change. More than half of the sample felt improved or much improved after FS.
UNASSIGNED: FS can be effective in reducing WRP and restoring foot posture in CMT patients in the short-term, which allows them to wear shoes, and leads to a perceived improvement and satisfaction. Lack of improvement in functional skills may be due to muscle weakness typical of CMT. Studies with longer follow-ups may confirm these hypotheses.