Footdrop, foot rotation, and plantarflexor failure in Charcot-Marie-Tooth disease.

Objective: To evaluate the frequency of occurrence of the main causes of poor stance and gait in patients with Charcot-Marie-Tooth disease (footdrop graded as mild or severe, rotation, and plantarflexor failure) both as single and associated problems.

Design: Observational.

Setting: A neuromuscular disorders department in a specialized Italian rehabilitation hospital.

Participants: One hundred twenty-six nonoperated lower limbs from 64 outpatients.

Interventions: Ankle angle during active dorsiflexion and heel angle in stance were measured in a photograph; the ability to raise the heel at least 2cm was evaluated.

Main Outcome Measures: Frequency of mild footdrop (ankle angle < or =100 degrees ), severe footdrop (ankle angle >100 degrees ), and rotation and plantarflexor failure singularly and in association.

Results: Mild footdrop was present in 47.6% of examined limbs and was associated with rotation in 39.7% of limbs; severe footdrop was present in 52.4% of limbs and was associated with rotation in 28.6% of limbs, with rotation plus plantarflexor failure in 21.4% of limbs.

Conclusions: We recommend categorizing problems in the lower limbs into 4 levels of increasing symptom severity, starting with mild footdrop and graduating to the instance where the 3 problems are associated.