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Section 1: Postural Control (c) 2011 Beverly Cusick, PT, MS, COF 1 1 New Paradigms in Equinus Deformity Management Supporting Sciences Beverly Cusick, PT, MS – Progressive GaitWays  AOPA Assembly Educational Program September 20, 2011 2 1. Find shor tene d & stiff triceps sura e. 2. Try to incre ase DFROM (gain/regain normal length) 3. Try to u se new length. 4. Repe at . The Typical EQD Management Paradigm 3 The Evident Rationale for this Paradigm Ø Ankle PF is BAD! BAD! Ø Spasticity causes EQD. Ø Contractures cause movement disorder. Ø Contracted muscle is too strong & must be weakened must be weakened to allow the antagonist(s) to activate. 4 Typical EQD Management Stream 1. Str et ch in g (doesn’t work, actually) 2. Add BTX-A inje ction for “spas ticity ” (=paralysis) 2.  Add 0 o -PF AFO(s) (unimpressive data) 3. Ano the r BTX-A i nje ction (doesn’t “work” on defo rmity) 4. Add c ast ing t o BTX-A injecti on (no gain from BTX) 6. Give up, go to surgery & cut everything possible (variable outcomes, common recurrence) 7. Hop e for the ROM ga in t o last >1 year or 2 8. Rep eat o r continue…..

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http://www.gaitways.com/
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