Changes in tibialis anterior muscle activity following tibial nerve block in adults with spastic equinovarus foot: an observational pilot study.
Alessandro Picelli, Mirko Filippetti, Angelo Pontillo and 5 others
PMID 41327613WHAT IT FOUND
In adults with spastic foot, a temporary nerve block improved passive ankle movement and reduced muscle tone.
Unexpectedly, activity in the front shin muscle also decreased during walking. This likely reflects reduced struggle against stiffness, not weakness, but actual gait changes were not measured.
Key findings
01The nerve block significantly improved passive ankle dorsiflexion and reduced spasticity scores immediately after administration.
02Surface EMG showed a significant decrease in activation area for both the calf muscle (targeted) and the shin muscle (not targeted) during walking.
03The study did not collect gait kinematics, so it cannot confirm if the reduced shin muscle activity improved or worsened actual foot clearance during walking.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was very small (13 participants), limiting generalizability. Gait kinematics (actual movement angles) were not recorded, so it is impossible to know if the reduced shin muscle activity improved or worsened foot clearance during walking. Assessments were only performed immediately before and after the block, so the duration of any effect is unknown. Walking speed was self-selected and not standardized, which can influence EMG amplitude. Phase-specific EMG analysis (stance vs. swing) was not performed, so the reduction in shin muscle activity is a whole-cycle average and may mask important timing changes.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the decrease in shin muscle (tibialis anterior) EMG activity as evidence of weakness or impaired function. The authors suggest this reduction likely reflects a normalization of muscle effort because the shin no longer has to fight against spastic calf resistance, but without kinematic data, the actual effect on foot clearance remains unproven.
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