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. 2018;30(2):281-295.
doi: 10.1007/s10882-017-9585-6. Epub 2018 Jan 2.

Abnormal Foot Position and Standing and Walking Ability in Rett Syndrome: an Exploratory Study

Hanneke E Borst  1   2 , Gillian S Townend  1 , Mirjam van Eck  3   4 , Eric Smeets  1 , Mariëlle van den Berg  5   6 , Aleid Laan  7   8 , Leopold M G Curfs  1
Affiliations

Abnormal Foot Position and Standing and Walking Ability in Rett Syndrome: an Exploratory Study

Hanneke E Borst et al. J Dev Phys Disabil. 2018.

Abstract

This study aimed to determine whether there is a relationship between abnormal foot position and standing and walking ability in individuals with Rett syndrome (RTT), a rare neurological condition primarily affecting females, often accompanied by impaired gross motor function and musculoskeletal deformities. Through means of an online survey, physiotherapists were asked to share information about their work and experience with individuals with RTT. They were asked about their clients' scores on the Rett Syndrome Gross Motor Scale and measures of their foot deformity, passive range of motion of dorsiflexion of the foot, use of supportive footwear, pressure load on the foot, and symmetry in weight bearing. 45 physiotherapists gave answers relating to 67 individuals with RTT who ranged in age from 2 to over 50 years. Almost 80% had an abnormal foot position which required support of special shoes or orthoses. Approximately 55% experienced abnormal pressure load on the foot and 65% demonstrated asymmetrical weight-bearing; 22% could sit independently and 17% were able to stand and walk independently. Of all the variables investigated, only abnormal distribution of pressure on the foot and asymmetry in weight bearing through the legs were found to be (negatively) correlated with standing and walking ability. Physiotherapists can use this information to give advice on othopedic support for the feet of individuals with RTT.

Keywords: Foot deformities; Orthosis; Rett Syndrome Gross Motor Scale; Rett syndrome; Walking; Weight bearing.

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Conflict of interest statement

Compliance with Ethical StandardsAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.This study conformed with Dutch law. Under Dutch law informed consent is not required from individual subjects for retrospective casenote studies. No identifying client data was collected.The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Average scores on the standing and walking subscale according to abnormal foot position
Fig. 2
Fig. 2
Average scores on the standing and walking subscale according to type of foot support
Fig. 3
Fig. 3
Frequencies of abnormal pressure load on the foot by age group
Fig. 4
Fig. 4
Relationship between age and PROM dorsiflexion of right ankle
Fig. 5
Fig. 5
Relationship between age and PROM dorsiflexion of left ankle
See this image and copyright information in PMC

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