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首页> 外文期刊>Journal of Clinical and Diagnostic Research >An Accelerated Multi-Modality Rehabilitation Protocol Combined with Botulinum Toxin-A Injection in Adult Idiopathic Toe Walking: Case Report
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An Accelerated Multi-Modality Rehabilitation Protocol Combined with Botulinum Toxin-A Injection in Adult Idiopathic Toe Walking: Case Report

机译：成人特发性脚趾踩踏结合肉毒杆菌毒素A注射加速多模式康复协议：病例报告

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Diagnosis of Adult Idiopathic Toe Walking (AITW) is very rare in clinical practice. High quality studies regarding AITW and its treatment options have not been conducted previously. A 28-year-old male patient complaining of lower leg pain was referred to outpatient rehabilitation clinic. Physical examination revealed a gait abnormality of insufficient heel strike at initial contact. The aetiology was investigated and the patient?s walking parameters were assessed using a computerized gait analysis system. The AITW was diagnosed. Botulinum toxin-A (Dysport?) was injected to the bilateral gastrocnemius muscles. A combined 10-days rehabilitation program was designed, including a daily one-hour physiotherapist supervised exercise program, ankle dorsiflexion exercises using an EMG-biofeedback unit assisted virtual rehabilitation system (Biometrics) and virtual gait training (Rehawalk) every other day. After treatment, the patient was able to heel strike at the initiation of the stance phase of the gait. Ankle dorsiflexion range of motions increased. The most prominent improvement was seen in maximum pressure and heel force. In addition center of pressure evaluations were also improved. To the best of our knowledge this is the first case, of AITW treated with combined botulinum toxin, exercise and virtual rehabilitation systems. This short report demonstrates the rapid effect of this 10-days combined therapy.
机译：成人特发性脚趾走路（AITW）的诊断在临床实践中非常罕见。以前尚未进行过有关AITW及其治疗方案的高质量研究。一名抱怨小腿疼痛的28岁男性患者被转诊至门诊康复诊所。体格检查发现初次接触时脚后跟撞击不足的步态异常。使用计算机步态分析系统调查病因并评估患者的步行参数。 AITW被诊断出。将肉毒毒素A（Dysport？）注射到双侧腓肠肌。设计了一个组合的10天康复计划，包括每天一小时的物理治疗师监督锻炼计划，使用EMG生物反馈单元辅助的虚拟康复系统（Biometrics）和每两天进行的虚拟步态训练（Rehawalk）进行的踝背屈锻炼。治疗后，患者能够在步态站立阶段开始时进行脚跟撞击。踝背屈运动范围增加。最大压力和后跟力是最明显的改进。此外，压力评估中心也得到了改善。就我们所知，这是第一例用肉毒毒素，运动和虚拟康复系统联合治疗的AITW。这份简短的报告证明了这种为期10天的联合疗法的快速效果。

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