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Cerebrovascular accidents.

K L Izzo1, S Aravabhumi

  • 1Temple University School of Medicine, Philadelphia, Pennsylvania.

Clinics in Podiatric Medicine and Surgery
|October 1, 1989
PubMed
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Cerebrovascular accident (CVA) rehabilitation requires accurate assessment of motor and intellectual deficits. Surgical interventions effectively correct lower extremity deformities like contractures and spasticity, improving ambulation in hemiplegic patients.

Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Orthopedic Surgery

Background:

  • Cerebrovascular accident (CVA) presents diverse clinical challenges based on infarction location.
  • Accurate assessment of sensory, motor, and intellectual deficits is crucial for effective rehabilitation goal setting.
  • Spasticity and contractures in the lower extremities are common sequelae, impacting mobility and function.

Purpose of the Study:

  • To outline the evaluation and management strategies for motor deficits and deformities following CVA.
  • To detail both conservative and surgical orthopedic interventions for lower extremity deformities in hemiplegic patients.
  • To emphasize the importance of accurate assessment in achieving functional ambulation goals.

Main Methods:

  • Clinical evaluation of sensory and motor systems, including intellectual status.

Related Experiment Videos

  • Utilizing poly-EMG analysis and nerve/motor point blocks for deformity assessment.
  • Reviewing medical rehabilitation techniques (mobilization, exercises, AFOs, FES) and orthopedic surgical procedures (tendon lengthening, soft-tissue release, tendon transfer).

    • Main Results:

    • Common deformities include hip flexion/adduction contractures, knee flexion contractures, and ankle equinus/varus/equinovarus.
    • Functional ambulation requires balance, hip flexion, leg stability, and cognitive ability.
    • Surgical correction of specific deformities (e.g., TAL for equinus, SPLATT for varus, hamstring release for knee flexion) can restore function.

    Conclusions:

    • Comprehensive evaluation is key to tailoring rehabilitation for CVA patients.
    • Orthopedic interventions, particularly surgery, are vital for correcting persistent lower extremity deformities when conservative measures fail.
    • Effective management strategies, combining medical and surgical approaches, can significantly improve ambulation and quality of life for individuals with CVA.