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Master Thesis

Quantification de la force des muscles fléchisseurs dorsaux de cheville dans la prise en charge de l'hypertonie spastique du triceps sural : mise en place d’un protocole de recherche clinique

Abstract : Introduction: Neurological foot represents a major functional and economic issue. It’s management depends largely on the etiopathological mechanism. Deforming spastic parésia following stroke may be managed by botulinum toxin injection. Nervus blocks are a diagnostic tool that can simplify the analysis of the various elements that characterize it. Commonly used clinical scales lack precision in an analysis that is intended to be as rigorous as possible. The intent here is to provide evidence on the management of spastic hypertonia of the sural triceps by quantifying dorsal ankle flexor muscles strength. It therefore seems interesting to describe this quantifying method of strengh and spasticity in the spastic hemiparetic ankle and its relevance in clinical practice. Materials and methods: Comparative, randomised, prospective multicenter interventional study of isokinetik analysis of foot elevator strength and resistance to stretch in patients with spastic paresia of a lower limb, with déambulation capacity and spastic hypertonia of the triceps surae folowing stroke. Patients will be included at “Le Normandy” center in Granville and in the PMR département of the UHC in Caen. The primary endpoint was the comparison of the results of the strength of the elevators before and after the nervous block of the soleus and gastorcnemii, the secondary endpoints will be based on the comparison of ankle mobility, the straight or bent knee position influence, the different speeds, the link with clinical scales and the walking functional résult, and the appréciation and assessment of the usefulness and acceptability of this instrument for patients. Discussion: Thanks to its instrumental and objective nature, despite the technical and economic limitation, this analysis method has many advantages over clinical assessment alone. This study promises to be of high statistical power. This enables the primary endpoint conclusion, and is sufficient to consider the secondary endpoints. It seems worthwhile to develop an instrumental method in order to combine the advantages of clinical analysis and isokinetic evaluation. Conclusion: This study is ambitious and difficult to set up. However, its originality allows us to describe a method unused in deforming spastic paresis of the ankle, and figure out alternatives for diagnostic analysis.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03586990
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Submitted on : Thursday, February 24, 2022 - 11:39:50 AM
Last modification on : Saturday, April 9, 2022 - 3:43:43 AM

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  • HAL Id : dumas-03586990, version 1

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Cristiana Su Viganò. Quantification de la force des muscles fléchisseurs dorsaux de cheville dans la prise en charge de l'hypertonie spastique du triceps sural : mise en place d’un protocole de recherche clinique. Médecine humaine et pathologie. 2021. ⟨dumas-03586990⟩

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