Foot and ankle deformities in stroke: relationship with ambulation, balance, and daily living activities: a cross-sectional study

Abstract

Background

Ankle–foot deformities play a critical role in functional capacity and therefore activities of daily living in stroke patients.

Aim

This is the first study to evaluate all foot deformities in stroke patients together. The primary aim of this study is to determine the frequency of ankle–foot deformities in stroke patients. The secondary aim is to investigate the relationships between ankle–foot deformities and ambulation, postural control, balance, spasticity, and activities of daily living.

Material and methods

The Functional Ambulation Classification was used to assess ambulation status, Postural Assessment Scale for Stroke Patients was used to assess postural control and balance. Lower extremity spasticity was evaluated with Modified Ashworth Scale. Activities of daily living were evaluated with Barthel Index.

Results

Ankle–foot deformity was detected in 77 (42%) of 184 cases. The incidence of pes equinovarus was 48%, pes equinus was seen in 22%, claw toe in 19.5%, and pes varus in 10.4%. Pes equinovarus and claw toe were seen together in 8 cases. In the group with ankle–foot deformity, the disease duration was longer and the rate of spasticity in the lower extremity was statistically higher (p = 0.29, p = 0.023). There was no difference in Functional Ambulation Classification, Barthel Index, and Postural Assessment Scale for Stroke Patients scores between patients with or without ankle–foot deformity (p = 0.811, 0.321, 0.385).

Conclusion

It is important to detect ankle–foot deformities in stroke patients. Ankle–foot deformities are associated with spasticity in patients with stroke and are an important factor to be considered when determining the rehabilitation program.

Keywords:

• Ankle
• deformity
• foot
• spasticity
• stroke

Ethical approval

This study protocol was approved by Ankara Physical Medicine and Rehabilitation Government Hospital ethics committee. Ethics review boards at all participating centres approved the protocol. All participants provided written informed consent.

Disclosure statement

No potential conflict of interest was reported by the author(s).