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Evolution of foot manifestations in children with Charcot-Marie-Tooth disease

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We aimed to characterise foot and ankle strength, flexibility, morphology and symptoms in children with CMT1A. 81 children aged 2–16 y with CMT1A were objectively assessed for strength (dorsiflexion, plantarflexion, inversion, eversion) with hand-held dynamometry, ankle dorsiflexion flexibility using the weight bearing lunge and foot morphology with the Foot Posture Index (FPI)... Ankle dorsiflexion ranged from 7–41° (mean 25°, SD 7)... Compared to normal, ankle flexibility was lower in children at all ages with CMT1A... Interestingly, there were no significant correlations between ankle flexibility and age, height or body weight... Foot morphology ranged from a FPI of -12 to +11 (mean 2, SD 5). 35% of children exhibited pes cavus, 39% had normal feet and 26% had pes planus... There was a significant correlation between FPI and age (r = -0.47, p < 0.001), indicating the evolution of pes cavus during growth (Figure 2)... Compared to norms, foot morphology in preschool children with CMT1A did not differ, but from the age of 5 years, deviated from normal towards a more cavoid appearance... Difficulty heel walking occurred in 82% of children, 4% had difficulty tip-toe walking and 4% exhibited foot drop. 27% reported foot pain, 36% reported cramps, 72% described ankle instability, 63% reported frequent trips and 47% falls... Foot pain, cramps, toe-walking and foot drop worsened with age (p < 0.05)... Children with CMT1A experience foot weakness, contracture and deformity from an early age... These manifestations are expected to impact negatively on daily function.

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Foot dorsiflexion weakness in CMT.
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Figure 1: Foot dorsiflexion weakness in CMT.

Mentions: Mean strength was: dorsiflexion 55N (SD, 20), plantarflexion 175N (SD, 49), inversion 76N (SD, 29), eversion 63N (SD, 24). While age (r = 0.65–0.80, p < 0.001) correlated with foot strength, compared to age-equivalent norms, mean strength was lower in all ages of childhood CMT1A. This disparity was most evident for dorsiflexion (Figure 1).


Evolution of foot manifestations in children with Charcot-Marie-Tooth disease
Foot dorsiflexion weakness in CMT.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2562132&req=5

Figure 1: Foot dorsiflexion weakness in CMT.
Mentions: Mean strength was: dorsiflexion 55N (SD, 20), plantarflexion 175N (SD, 49), inversion 76N (SD, 29), eversion 63N (SD, 24). While age (r = 0.65–0.80, p < 0.001) correlated with foot strength, compared to age-equivalent norms, mean strength was lower in all ages of childhood CMT1A. This disparity was most evident for dorsiflexion (Figure 1).

View Article: PubMed Central - HTML

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

We aimed to characterise foot and ankle strength, flexibility, morphology and symptoms in children with CMT1A. 81 children aged 2–16 y with CMT1A were objectively assessed for strength (dorsiflexion, plantarflexion, inversion, eversion) with hand-held dynamometry, ankle dorsiflexion flexibility using the weight bearing lunge and foot morphology with the Foot Posture Index (FPI)... Ankle dorsiflexion ranged from 7–41° (mean 25°, SD 7)... Compared to normal, ankle flexibility was lower in children at all ages with CMT1A... Interestingly, there were no significant correlations between ankle flexibility and age, height or body weight... Foot morphology ranged from a FPI of -12 to +11 (mean 2, SD 5). 35% of children exhibited pes cavus, 39% had normal feet and 26% had pes planus... There was a significant correlation between FPI and age (r = -0.47, p < 0.001), indicating the evolution of pes cavus during growth (Figure 2)... Compared to norms, foot morphology in preschool children with CMT1A did not differ, but from the age of 5 years, deviated from normal towards a more cavoid appearance... Difficulty heel walking occurred in 82% of children, 4% had difficulty tip-toe walking and 4% exhibited foot drop. 27% reported foot pain, 36% reported cramps, 72% described ankle instability, 63% reported frequent trips and 47% falls... Foot pain, cramps, toe-walking and foot drop worsened with age (p < 0.05)... Children with CMT1A experience foot weakness, contracture and deformity from an early age... These manifestations are expected to impact negatively on daily function.

No MeSH data available.


Related in: MedlinePlus