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Use of a static adjustable ankle-foot orthosis following tibial nerve block to reduce plantar-flexion contracture in an individual with brain injury. Export

Physical therapy, Vol. 82, No. 11. (November 2002), pp. 1087-1097.

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ankle_foot_orthosis contracture limited_rom neurological_impairment neurology_phyiscal_therapy tibial_nerve_block traumatic_brain_injury

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BACKGROUND AND PURPOSE: Ankle plantar-flexion contractures are a common complication of brain injuries and can lead to secondary limitations in mobility. CASE DESCRIPTION: The patient was a 44-year-old woman with left hemiplegia following a right frontal arteriovenous malformation resection. She had a left ankle plantar-flexion contracture of -31 degrees from neutral. After a tibial nerve block, an adjustable ankle-foot orthosis was applied 23 hours a day for 27 days. Adjustments of the orthosis were made as the contracture was reduced. The patient received physical therapy during the 27-day period for functional mobility activities and stretching the plantar flexors outside of the orthosis. OUTCOMES: The patient's dorsiflexion passive range of motion increased from -31 degrees to +10 degrees. DISCUSSION: The application of an adjustable ankle-foot orthosis following a tibial nerve block, as an addition to a physical therapy regimen of stretching and mobility training, may reduce plantar-flexion contractures in patients with brain injury.


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