Orthotic fitting improves gait in a patient with generalized secondary dystonia.

OBJECTIVE To determine whether an orthotic fitting improved gait in an adult patient presenting with generalized secondary dystonia. PATIENT The patient had stance and gait disturbances associated with pain, ankle instability and fatigability. Clinical examination showed the presence of dystonia in the foot and ankle, along with equinovarus foot, mainly on the left side. The patient was fitted with a patellar tendon-bearing orthosis on the left side, orthopaedic shoes and plantar orthoses. METHODS The outcome of the treatment after 12 months was assessed on the basis of a physical examination and an instrumental gait assessment, using the GAITRite(R) system to analyse spatiotemporal parameters and force-plates to measure body weight distribution. RESULTS The fitting resulted in a significant improvement in gait, reduced pain and ankle instability, decreased cadence, increased step length and single foot support time, and reduced asymmetry of the temporo-spatial patterns and body weight distribution. CONCLUSION Patellar tendon-bearing orthoses and orthopaedic shoes could provide a good therapeutic approach for improving gait in patients with generalized secondary dystonia.