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Blouin C, Perrier A, Denormandie P, Genêt F. Relationship between care pathway features and use or non-use of orthotic devices by individuals with Charcot-Marie-Tooth disease: a cross-sectional, exploratory study. Disabil Rehabil 2024; 46:2155-2165. [PMID: 37147931 DOI: 10.1080/09638288.2023.2208883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 04/22/2023] [Indexed: 05/07/2023]
Abstract
PURPOSE Orthotic devices may be prescribed for the management of foot and ankle deformities caused by Charcot-Marie-Tooth disease (CMT). However, the actual use of these devices is variable. No studies have evaluated the impact of prescription, delivery and follow-up of orthotic devices on their use.We aimed to describe the relationship between the pathways followed by individuals with CMT and orthotic device use. MATERIALS AND METHODS Exploratory, cross-sectional, 35-item survey of orthotic device management. Individuals with CMT were recruited from CMT-France Association. RESULTS Of the 940 respondents, 795 were included, mean age of 52.9 (SD 16.9) years. Rate of orthotic device use was 49.2% (391/795). The most frequent reason for non-use was a poor fit. Non-use was related to the orthotic device type, the health professionals consulted, and the severity of the CMT-related impairments. Follow-up visits (38.7%), re-evaluation of orthotic devices (25.3%) and consultations with the Physical and Rehabilitation Medicine physician were infrequent (28.3%). CONCLUSIONS Orthotic devices are massively underused. Follow-up and re-evaluation are infrequent. Care pathways, prescription and delivery of orthotic devices must be optimized to meet the expectations of people with CMT. Device fitting, individual needs, and changes in the clinical state must be re-evaluated regularly by specialists to improve orthotic device use.
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Affiliation(s)
- Cédric Blouin
- Université Versailles Saint-Quentin-en-Yvelines (UVSQ); UFR Simone Veil - Santé, UR2020 Erphan, Montigny-le-Bretonneux, France
- Service de chirurgie orthopédique, hôpital de la Croix-Saint-Simon, Groupe Hospitalier Diaconesses- Croix-Saint-Simon, Paris, France
- ISPC-Synergies (Institut de Santé Parasport Connecté), Paris, France
| | - Antoine Perrier
- Service de chirurgie orthopédique, hôpital de la Croix-Saint-Simon, Groupe Hospitalier Diaconesses- Croix-Saint-Simon, Paris, France
- Laboratoire de recherche translationnelle et d'innovation en médecine et complexité TIMC, CNRS, Grenoble, France
- Service de diabétologie, Groupe hospitalier Pitié-Salpêtrière, Paris, France
| | - Philippe Denormandie
- Service de chirurgie orthopédique, Hôpital Raymond Poincaré, APHP, Garches, France
- Groupe Mutuelle nationale des hospitaliers (MNH), Paris, France
| | - François Genêt
- ISPC-Synergies (Institut de Santé Parasport Connecté), Paris, France
- Unité Péri Opératoire du Handicap, (UPOH- Perioperative Disability Unit), Département PARASPORT- SANTE, service de Médecine Physique et de Réadaptation, Hôpital Raymond-Poincaré, Groupe Hospitalo-Universitaire APHP-Université PARIS SACLAY, Garches, France
- Université Versailles Saint-Quentin-en-Yvelines (UVSQ); UFR Simone Veil - Santé, END: ICAP, Montigny-le-Bretonneux, France
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Ferraro F, Calafiore D, Curci C, Fortunato F, Carantini I, Genovese F, Lucchini G, Merlo A, Ammendolia A, de Sire A. Effects of intensive rehabilitation on functioning in patients with mild and moderate Charcot-Marie-Tooth disease: a real-practice retrospective study. Neurol Sci 2024; 45:289-297. [PMID: 37552411 PMCID: PMC10761523 DOI: 10.1007/s10072-023-06998-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/14/2023] [Indexed: 08/09/2023]
Abstract
Charcot-Marie-Tooth (CMT) disease is one of the most common inherited neuropathies and can lead to progressive muscular weakness, pes cavus, loss of deep tendon reflexes, distal sensory loss, and gait impairment. There are still no effective drugs or surgical therapies for CMT, and supportive treatment is limited to rehabilitative therapy and surgical treatment of skeletal deformities. Many rehabilitative therapeutic approaches have been proposed, but timing and cadence of rehabilitative intervention are not clearly defined, and long-term follow-up is lacking in literature. The aim of this real-practice retrospective study was to assess the effectiveness of an intensive neurorehabilitation protocol on muscle strength and functioning in CMT patients. We analyzed data of patients with diagnosis of mild to moderate CMT. The rehabilitation program lasted 2-4 h a day, 5 days a week, for 3 weeks and consisted of manual treatments, strengthening exercises, stretching, core stability, balance and resistance training, aerobic exercises, and tailored self-care training. Data were collected at baseline (T0), after treatment (T1), and at the 12-month mark (T2) in terms of the following outcome measures: muscle strength, pain, fatigue, cramps, balance, walking speed, and ability. We included 37 CMT patients with a median age of 50.72 ± 13.31 years, with different forms: demyelinating (n = 28), axonal (n = 8), and mixed (n = 1). After intensive rehabilitation treatment, all outcomes significantly improved. This improvement was lost at the 1-year mark. Taken together, these findings suggest that an intensive rehabilitation program improves short-term symptoms and functional outcomes in a cohort of inpatients affected by mild to moderate CMT.
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Affiliation(s)
- Francesco Ferraro
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100, Mantova, Italy
| | - Dario Calafiore
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100, Mantova, Italy
| | - Claudio Curci
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100, Mantova, Italy
| | - Francesco Fortunato
- Institute of Neurology, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", 88100, Catanzaro, Italy
| | - Irene Carantini
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100, Mantova, Italy
- ACMT-Rete per la malattia di Charcot-Marie-Tooth OdV Association, Rome, Italy
| | - Filippo Genovese
- ACMT-Rete per la malattia di Charcot-Marie-Tooth OdV Association, Rome, Italy
| | | | - Andrea Merlo
- LAM-Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
| | - Antonio Ammendolia
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University Hospital "Mater Domini", University of Catanzaro Magna Graecia, Via Campanella, 115-88100, Catanzaro, Italy
| | - Alessandro de Sire
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University Hospital "Mater Domini", University of Catanzaro Magna Graecia, Via Campanella, 115-88100, Catanzaro, Italy.
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de Jong LAF, Kerkum YL, Altmann VC, Geurts ACH, Keijsers NLW. Orthopedic footwear has a positive influence on gait adaptability in individuals with hereditary motor and sensory neuropathy. Gait Posture 2023; 106:18-22. [PMID: 37639960 DOI: 10.1016/j.gaitpost.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/30/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Individuals with Hereditary Motor and Sensory Neuropathy (HMSN) are commonly provided with orthopedic footwear to improve gait. Although orthopedic footwear has shown to improve walking speed and spatiotemporal parameters, its effect on gait adaptability has not been established. RESEARCH QUESTION What is the effect of orthopedic footwear on gait adaptability in individuals with HMSN? METHODS Fifteen individuals with HMSN performed a precision stepping task on an instrumented treadmill projecting visual targets, while wearing either custom-made orthopedic or standardized footwear (i.e. minimally supportive, flexible sneakers). Primary measure of gait adaptability was the absolute Euclidean distance [mm] between the target center and the middle of the foot (absolute error). Secondary outcomes included the relative and variable error [mm] in both anterior-posterior (AP) and medial-lateral (ML) directions. Dynamic balance was assessed by the prediction of ML foot placement based on the ML center of mass position and velocity, using linear regression. Dynamic balance was primarily determined by foot placement deviation in terms of root mean square error. Another aspect of dynamic balance was foot placement adherence in terms of the coefficient of determination (R2). Differences between the footwear conditions were analyzed with a paired t-test or Wilcoxon signed-rank test (α = 0.05). RESULTS The absolute error, relative error (AP) and variable error (AP and ML) decreased with orthopedic footwear, whereas the relative error in ML-direction slightly increased. As for dynamic balance, no effect on foot placement deviation or adherence was found. SIGNIFICANCE Gait adaptability improved with orthopedic compared to standardized footwear in people with HMSN, as indicated by improved precision stepping. Dynamic balance, as a possible underlying mechanism, was not affected by orthopedic footwear.
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Affiliation(s)
- Lysanne A F de Jong
- Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands; Research and Development, OIM Orthopedie, Assen, the Netherlands; Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Yvette L Kerkum
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Viola C Altmann
- Klimmendaal Revalidatie Specialisten, Arnhem, the Netherlands; Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, UK
| | - Alexander C H Geurts
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Noel L W Keijsers
- Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands; Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Sensorimotor Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
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de Jong LAF, Kerkum YL, Altmann VC, Geurts ACH, Keijsers NLW. Effects of orthopedic footwear on postural stability and walking in individuals with Hereditary Motor Sensory Neuropathy. Clin Biomech (Bristol, Avon) 2022; 94:105638. [PMID: 35405625 DOI: 10.1016/j.clinbiomech.2022.105638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/14/2022] [Accepted: 03/29/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Orthopedic footwear is often prescribed to improve postural stability during standing and walking in individuals with Hereditary Motor Sensory Neuropathy. However, supporting evidence in literature is scarce. The aim of this study was to investigate the effect of orthopedic footwear on quiet standing balance, gait speed, spatiotemporal parameters, kinematics, kinetics and dynamic balance in individuals with Hereditary Motor Sensory Neuropathy. METHODS Fifteen individuals with Hereditary Motor Sensory Neuropathy performed a quiet standing task and 2-min walk test on customized orthopedic footwear and standardized footwear. Primary outcome measures were the mean velocity of the center of pressure during quiet standing and gait speed during walking. Secondary outcome measures included center of pressure amplitude and frequency during quiet standing, and spatiotemporal parameters, kinematics, kinetics, and dynamic balance during walking. Two-way repeated measures ANOVA and paired t-tests were performed to identify differences between footwear conditions. FINDINGS Neither quiet standing balance nor dynamic balance differed between orthopedic and standardized footwear, but orthopedic footwear improved spatiotemporal parameters (higher gait speed, longer step length, shorter step time and smaller step width) during walking. Moreover, less sagittal shank-footwear range of motion, more frontal shank-footwear range of motion, more dorsiflexion of the footwear-to-horizontal angle at initial contact and more hip adduction during the stance phase were found. INTERPRETATION Orthopedic footwear improved walking in individuals with Hereditary Motor Sensory Neuropathy, whereas it did not affect postural stability during quiet standing or dynamic balance. Especially gait speed and spatiotemporal parameters improved. An improved heel landing at initial contact for all footwear and reduced foot drop during swing for mid and high orthopedic footwear contributed to the gait improvements wearing orthopedic footwear.
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Abstract
Formin proteins catalyze actin nucleation and microfilament polymerization. Inverted formin 2 (INF2) is an atypical diaphanous-related formin characterized by polymerization and depolymerization of actin. Accumulating evidence showed that INF2 is associated with kidney disease focal segmental glomerulosclerosis and cancers, such as colorectal and thyroid cancer where it functions as a tumor suppressor, glioblastoma, breast, prostate, and gastric cancer, via its oncogenic function. However, studies on the underlying molecular mechanisms of the different roles of INF2 in diverse cancers are limited. This review comprehensively describes the structure, biochemical features, and primary pathogenic mutations of INF2.
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Affiliation(s)
- Yiting Zhao
- Department of Hepato-Biliary-Pancreatic Surgery, The Affiliated Ningbo Medical Center of LiHuiLi Hospital of Medical School of Ningbo University, Ningbo, 315048, China.,The Affiliated Hospital of Medical School, Ningbo University, Ningbo, 315020, China
| | - Hui Zhang
- Department of Biochemistry and Molecular Biology, and Zhejiang Key Laboratory of Pathophysiology, Medical School of Ningbo University, Ningbo, 315211, China.,The Affiliated Hospital of Medical School, Ningbo University, Ningbo, 315020, China
| | - Haibiao Wang
- Department of Hepato-Biliary-Pancreatic Surgery, The Affiliated Ningbo Medical Center of LiHuiLi Hospital of Medical School of Ningbo University, Ningbo, 315048, China. .,Department of Biochemistry and Molecular Biology, and Zhejiang Key Laboratory of Pathophysiology, Medical School of Ningbo University, Ningbo, 315211, China.
| | - Meng Ye
- Department of Biochemistry and Molecular Biology, and Zhejiang Key Laboratory of Pathophysiology, Medical School of Ningbo University, Ningbo, 315211, China. .,The Affiliated Hospital of Medical School, Ningbo University, Ningbo, 315020, China.
| | - Xiaofeng Jin
- Department of Biochemistry and Molecular Biology, and Zhejiang Key Laboratory of Pathophysiology, Medical School of Ningbo University, Ningbo, 315211, China. .,The Affiliated Hospital of Medical School, Ningbo University, Ningbo, 315020, China.
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