Description

Charcot-Marie-Tooth Disease (CMT) is a hereditary disease characterized by a slowly progressing muscle weakness in the limbs and a loss of sensation in the fingers, feet and toes caused by peripheral neuropathy. The initial symptom of drop foot is seen early in the course of the disease. High arched feet (pes cavus) are associated with the disorder.

Symptoms

Clients may first complain of lesser toe deformities, feeling clumsy, easily tripping, difficulty with walking and stubbing their toes. They may complain of pain under the forefoot or on the lateral border of the foot. Muscle spasms and painful cramping of the lower limb and foot have also been commonly reported as symptoms of the disease.

Pedorthic Management

CMT is a progressive disease and management should focus on the prevention and treatment of foot deformities, maintaining lateral stability, management of foot drop, and the distribution of plantar pressure.

• Custom made orthotics – lateral forefoot/rearfoot posting for lateral stability.
• Orthopedic footwear – properly fitted, strong, structured footwear – high top shoes with a deep toe box, and lace or velcro closures.
• Footwear modifications – lateral flares/buttresses for added stability, rocker soles with a mild heel rocker.

Other Treatments/ Modalities

• Orthopedic surgical consultation – for surgical intervention to improve muscle balance and re-align bone structure.
• Physiotherapy and Massage Therapy –  to preserve muscle strength and range of motion.
• Orthotist – for upper and lower limb bracing such as an AFO (ankle foot orthosis) which may be indicated as the symptoms progresses.
• Podiatry –  to manage and prevent issues related to nails, skin, and wounds.