1 - Gait Disorders with Spastic Hemiparesis: Treatment with Nerve Blocks, Botulinum Toxins and Orthotics

Gait disorders in patients with spasticity and hemiparesis are common after brain injuries and stroke. Gait disorders are the clinical presentation of interactions among muscle weakness (hemiparesis), involuntary and synergistic activation of spastic muscles and ground reaction force during ambulation. Appropriate management of spasticity is required for best restoration of mechanical alignment of the kinetic chains, including ankle/foot, knee, joint and trunk. However, such complicated interactions are not well understood, and gait disorders with spasticity are often poorly treated. In this session, we will present a theoretical framework to advance our understanding of such complicated interactions, and we will present different treatment options for best clinical outcomes. Pros and cons of these treatment options will be discussed.