STUDY - Technical - New Dacian's Medicine
Footdrop
(Classical / Allopathic Medicine)
Footdrop - plantar
flexion of the foot with the toes bent toward the instep -
results from weakness or paralysis of the dorsiflexor muscles
of the foot and ankle. A characteristic and essential sign of
specific peripheral nerve or motor neuron disorders, footdrop
may also stem from prolonged immobility when inadequate
support, improper positioning, or infrequent passive exercise
produces shortening of the Achilles tendon. Unilateral foot
drop can result from compression of the common peroneal nerve
against the head of the fibula.
Footdrop can range
in severity from slight to complete, depending on the extent
of muscle weakness or paralysis. It develops slowly in
progressive muscle degeneration or suddenly in spinal cord
injury.
HISTORY:
Ask the patient about the sign's onset, duration, and character. Does the footdrop fluctuate in severity or remain constant? Does it worsen with fatigue or improve with rest?
Ask the patient if he feels weak or tired quickly.
Review the patient's medical history for neurologic disorders and spinal trauma.
Ask the patient about the sign's onset, duration, and character. Does the footdrop fluctuate in severity or remain constant? Does it worsen with fatigue or improve with rest?
Ask the patient if he feels weak or tired quickly.
Review the patient's medical history for neurologic disorders and spinal trauma.
PHYSICAL
ASSESSMENT:
Assess muscle tone and strength in the patient's feet and legs, and compare findings on both sides.
Assess deep tendon reflexes in both legs.
Have the patient walk, if possible; look for steppage gait - a compensatory response to footdrop. Also, inspect his shoes for wear.
Assess muscle tone and strength in the patient's feet and legs, and compare findings on both sides.
Assess deep tendon reflexes in both legs.
Have the patient walk, if possible; look for steppage gait - a compensatory response to footdrop. Also, inspect his shoes for wear.
SPECIAL
CONSIDERATIONS:
Prepare the patient for electromyography to evaluate nerve damage.
Prepare the patient for electromyography to evaluate nerve damage.
PEDIATRIC
POINTERS:
Common causes of foot drop in children include spinal birth defects, such as spina bifida, and degenerative disorders such as muscular dystrophy.
Common causes of foot drop in children include spinal birth defects, such as spina bifida, and degenerative disorders such as muscular dystrophy.
PATIENT
COUNSELING:
Refer the patient for physical therapy for gait retraining and, possibly, for in-shoe splints or leg braces to maintain correct foot alignment for walking and standing.
Refer the patient for physical therapy for gait retraining and, possibly, for in-shoe splints or leg braces to maintain correct foot alignment for walking and standing.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)