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Claw toes in hemiplegic patients after stroke
G Laurent1, F Valentini, K Loiseau
1Hôpital Charles-Foix, Ivry-sur-Seine, France.
Insights
Claw toes are common in hemiplegic stroke patients, often appearing early and linked to foot deformities. Early diagnosis and intervention are crucial for rehabilitation.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Podiatry
Background:
- Stroke frequently leads to motor impairments, affecting lower limb function.
- Claw toes, a deformity of the foot, can significantly impact gait and rehabilitation outcomes in post-stroke individuals.
Purpose of the Study:
- To determine the prevalence of claw toes in hemiplegic patients one year after stroke.
- To investigate the correlation between claw toes and other lower limb disorders, such as equinus and varus foot.
- To assess the relationship between claw toes and functional recovery in stroke survivors.
Main Methods:
- A prospective study involving 39 hemiplegic patients within one year post-stroke.
- Evaluations included assessing for claw toes, triceps surae spasticity, motor impairment, and functional abilities using the Barthel Index, PASS, and FAC.
- Data were collected through 64 evaluations conducted over a one-year period.
Main Results:
- Claw toes occurred in 46% (18 out of 39) of the patients.
- In 83% of affected patients, claw toes emerged within three months post-stroke.
- A significant association was found between claw toes and equinus and/or varus foot (p<0.0001).
Conclusions:
- Claw toes are a common and early complication in hemiplegic patients following a stroke.
- The presence of equinus and/or varus foot and achieving average functional capacities were associated with claw toes.
- Early diagnosis and management of claw toes are essential for optimizing patient rehabilitation and functional outcomes.
Objective:
The aim of this study was to analyze the prevalence of claw toes and its correlation to other lower limb disorders as well as the global functional recovery in a population of hemiplegic patients 1year post-stroke.
Patients And Methods:
This prospective study included 39 stroke patients hospitalized in the Physical Medicine and Rehabilitation (PM&R) department of a hospital between September2000 and September2001. The evaluation looked for incidence of claw toes during the first year post-stroke and whether there was a potential link to triceps surae spasticity, motor impairment of the leg and patients' functional abilities (Barthel Index, postural assessment scale for stroke patients [PASS], functional ambulation classification [FAC]).
Results:
We conducted a total of 64 evaluations (one to four by patient). In 18 out of 39 (46%) patients, we found an occurrence of claw toes. In 15 out of 18 (83%) patients, who regained average functional capacities, its onset took place before the end of the third month post-stroke (Barthel: 30-70, PASS: 15-33, FAC: 3-4) and it was significantly linked to equinus and/or varus foot (p<0.0001).
Conclusion:
The occurrence of claw toes in hemiplegic patients is common and happens early on post-stroke. Equinus and/or varus foot and average functional capacities were associated to claw toes. Despite the few studies devoted to this condition in stroke patients, this condition must be diagnosed early and taken into account to improve the patient's rehabilitation care.
