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Surgical correction of foot deformities in Charcot-Marie-Tooth-disease: effects on personal goals and gait capacity
Heleen van der Wielen1, Jorik Nonnekes2, Michelle van Mierlo3
1Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands; Research Department, Sint Maartenskliniek, Nijmegen, the Netherlands.
Abstract:
Charcot Marie Tooth disease (CMT) is the most common group of inherited muscular disorders, resulting in foot deformities. Foot and ankle surgical procedures are frequently performed to improve function in persons with CMT. Understanding the patients' personal goals is crucial for effective counselling. However, there is limited evidence regarding the extent to which personal goals are achieved through surgery, as well as the impact of surgery on balance and gait capacity. A prospective cohort study was conducted in 28 persons with CMT who underwent surgery. A wide range of personal goals was identified using the Canadian Occupational Performance Measure (COPM), with the most common goal being 'less problems during walking on uneven ground with shoes'. Wilcoxon signed-rank revealed a significant improvement in mean COPM scores after surgery for both performance (median difference: 3.0, range: -2 to 8; p < 0.001) and satisfaction (3.5, -2 to 9; p ≤ 0.001). Mini-BESTest (balance capacity) also showed significant improvement (17.0 to 20.3 points, p < 0.001), whereas gait (gait velocity, gait width, and single support time) remained unchanged. This study highlights the variability in personal goals, with an overlap on individual and group levels. After surgery, balance capacity improved, both objectively and subjectively.

