Management of gait impairments in people with hereditary motor and sensory neuropathy: A treatment algorithm.

Gait impairments in people with hereditary motor and sensory neuropathy (also known as Charcot-Marie-Tooth disease) are the combined result of ankle-foot deformities, muscle weakness, and somatosensory impairments. People with hereditary neuropathies often experience pain and difficulties when walking, especially barefoot. They also trip and fall frequently and have a lower than normal gait speed and distance. Because these gait impairments and related complaints are disabling, clinical management aimed at improving gait is important. Management involves both conservative and surgical treatment options, each with limited scientific evidence. However, a treatment algorithm that describes both conservative and surgical treatment options is currently lacking. This study sets out a step-wise treatment algorithm, based on evidence, if available, and otherwise reflecting practice-based experience. The treatment algorithm will be of value in daily clinical practice, and will serve as a template for future research.