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Background and Purpose. Ankle plantar-flexion contractures are a common complication of brain injuries and can lead to secondary limitations in mobility. Case Description. The patient was a 44-year-old woman with left hemiplegia following a right frontal arteriovenous malformation resection. She had a left ankle plantar-flexion contracture of −31 degrees from neutral. After a tibial nerve block, an adjustable ankle-foot orthosis was applied 23 hours a day for 27 days. Adjustments of the orthosis were made as the contracture was reduced. The patient received physical therapy during the 27-day period for functional mobility activities and stretching the plantar flexors outside of the orthosis. Outcomes. The patient's dorsiflexion passive range of motion increased from −31 degrees to +10 degrees. Discussion. The application of an adjustable ankle-foot orthosis following a tibial nerve block, as an addition to a physical therapy regimen of stretching and mobility training, may reduce plantar-flexion contractures in patients with brain injury.

Use of a Static Adjustable Ankle-Foot Orthosis Following Tibial Nerve Block to Reduce Plantar-Flexion Contracture in an Individual With Brain Injury