{"id":148,"date":"2020-02-17T08:44:35","date_gmt":"2020-02-17T06:44:35","guid":{"rendered":"https:\/\/roneuro.ro\/blog\/piciorul-cazut-foot-drop\/"},"modified":"2025-03-26T12:47:58","modified_gmt":"2025-03-26T10:47:58","slug":"piciorul-cazut-foot-drop","status":"publish","type":"post","link":"https:\/\/roneuro.ro\/blog\/piciorul-cazut-foot-drop\/","title":{"rendered":"Piciorul c\u0103zut (\u201cFoot drop\u201d)"},"content":{"rendered":"\n<h2>Ce este piciorul c\u0103zut?<\/h2>\n<p>Piciorul c\u0103zut reprezint\u0103 un aspect destul de des \u00eent\u00e2lnit \u00een practica clinic\u0103, av\u00e2nd la baz\u0103 o afec\u021biune neurologic\u0103, precum un <a href=\"https:\/\/roneuro.ro\/blog\/accidentul-vascular-cerebral\/\">accident vascular cerebral<\/a>.<\/p>\n<p>Acesta se observ\u0103 atunci c\u00e2nd persoanele nu pot ridica partea din fa\u021b\u0103 a piciorului din cauza sl\u0103biciunii sau paraliziei mu\u0219chilor necesari pentru aceast\u0103 ac\u021biuni. Adesea, pacien\u021bii t\u00e2r\u0103sc piciorul \u00een timpul mersului, fiind un factor de risc pentru instabilitatea gleznei \u0219i a genunchilor, duc\u00e2nd la probleme de echilibru.<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter wp-image-1552\" src=\"https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Statistics-scaled.jpg\" alt=\"\" width=\"600\" height=\"278\" title=\"\" srcset=\"https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Statistics-scaled.jpg 2560w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Statistics-300x139.jpg 300w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Statistics-1024x475.jpg 1024w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Statistics-768x357.jpg 768w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Statistics-1536x713.jpg 1536w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Statistics-2048x951.jpg 2048w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Statistics-750x348.jpg 750w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/Statistics-1140x529.jpg 1140w\" sizes=\"(max-width: 600px) 100vw, 600px\" \/><\/p>\n<p>\u00cen func\u021bie de cauz\u0103, poate fi afectat unul sau ambele picioare. Deseori aceast\u0103 manifestare este temporar\u0103, dar poate fi \u0219i permanent\u0103.<\/p>\n<h2>Cum se manifest\u0103 piciorul c\u0103zut?<\/h2>\n<p>Pacientul are dificult\u0103\u021bi \u00een a ridica extremitatea membrului inferior (laba piciorului) de pe sol. Mersul este \u0219chiop\u0103tat, genunchiul este ridicat mai sus ca de obicei \u00een scop compensator, astfel \u00eenc\u00e2t piciorul c\u0103zut s\u0103 nu se t\u00e2rasc\u0103 pe podea (mers stepat). Dac\u0103 nu ar face aceast\u0103 manevr\u0103, persoana afectat\u0103 s-ar \u00eempiedica \u00een piciorul bolnav.<\/p>\n<p>Piciorul c\u0103zut poate cauza mers \u00eencetinit, oboseal\u0103, consum mai mare de energie, durere local\u0103 \u00een zona de compresie a nervului, sensibilitate pe partea lateral\u0103 a gambei \u0219i dorsal\u0103 a piciorului, toate acestea put\u00e2nd s\u0103 fie urmate de c\u0103z\u0103turi [1].<\/p>\n<p>\u00cen schimb, sensibilitatea este normal\u0103 pe fa\u021ba extern\u0103 a piciorului, talp\u0103, fa\u021ba intern\u0103 a piciorului \u0219i fa\u021ba lateral\u0103 a genunchiului \u2013 teritorii deservite de al\u021bi nervi ai gambei \u0219i piciorului.<\/p>\n<p>Mi\u0219c\u0103rile din articula\u021bia genunchiului \u0219i articula\u021bia \u0219oldului, precum \u0219i reflexele rotulian \u0219i ahilian sunt normale.<\/p>\n<p>Riscul de afectare a nervului peroneal cre\u0219te dac\u0103:<\/p>\n<ul>\n<li>Sta\u021bi adesea cu picioarele \u00eencruci\u0219ate la nivelul genunchiului;<\/li>\n<li>Ave\u021bi piciorul \u00een ghips;<\/li>\n<li>Sunte\u021bi \u00een repaus la pat;<\/li>\n<li>A\u021bi pierdut \u00een greutate.<\/li>\n<\/ul>\n<h2>Care sunt cauzele piciorului c\u0103zut?<\/h2>\n<p>De cele mai multe ori piciorul c\u0103zut este consecin\u021ba<strong> compresiei unui nerv pe fa\u021ba lateral\u0103 a genunchiului<\/strong>, unde vine \u00een contact cu unul din oasele gambei \u2013 fibula. Aceast\u0103 leziune poate ap\u0103rea \u00een urma unei leziuni grave sau \u00een timpul unei interven\u021bii chirurgicale de \u00eenlocuire a \u0219oldului sau a genunchiului. Tipurile de leziuni includ:<\/p>\n<ul>\n<li>Fractura gleznei;<\/li>\n<li>Fractura peroneului;<\/li>\n<li>Dislocarea genunchiului;<\/li>\n<li>Fractura genunchiului.<\/li>\n<\/ul>\n<p>O alt\u0103 cauz\u0103 poate fi <strong>leziunea r\u0103d\u0103cinii nervoase la nivelul coloanei vertebrale<\/strong>. Tulbur\u0103rile nervoase asociate cu piciorul c\u0103zut sunt mai comune la persoanele care sufer\u0103 de<strong> diabet<\/strong>.<\/p>\n<p>Piciorul c\u0103zut poate ap\u0103rea \u0219i \u00een urma unor <strong>tulbur\u0103ri musculare sau nervoase<\/strong> precum distrofiile musculare ereditare, sau afec\u021biuni neurologice precum poliomielita sau boala Charcot-Marie-Tooth.<\/p>\n<p>Uneori, o <strong>tumoare sau <\/strong>un<strong> chist<\/strong> la nivelul nervului poate cauza c\u0103derea piciorului. De asemenea, afec\u021biuni inflamatorii precum artrita reumatoid\u0103 sau lupusul pot afecta nervul [1,2].<\/p>\n<p>Alte afec\u021biuni cerebrale care pot provoca c\u0103derea piciorului includ:<\/p>\n<ul>\n<li><a href=\"https:\/\/roneuro.ro\/blog\/ce-este-scleroza-multipla\/\">Scleroza multipl\u0103<\/a>;<\/li>\n<li>Paralizie cerebral\u0103;<\/li>\n<li><a href=\"https:\/\/roneuro.ro\/blog\/dementa-de-tip-parkinson\/\">Boala Parkinson<\/a> [3].<\/li>\n<\/ul>\n<p><img decoding=\"async\" class=\"aligncenter wp-image-1553\" src=\"https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/cauze-picior-cazut.jpg\" alt=\"\" width=\"600\" height=\"573\" title=\"\" srcset=\"https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/cauze-picior-cazut.jpg 1600w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/cauze-picior-cazut-300x286.jpg 300w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/cauze-picior-cazut-1024x977.jpg 1024w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/cauze-picior-cazut-768x733.jpg 768w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/cauze-picior-cazut-1536x1466.jpg 1536w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/cauze-picior-cazut-750x716.jpg 750w, https:\/\/roneuro.ro\/blog\/wp-content\/uploads\/2020\/02\/cauze-picior-cazut-1140x1088.jpg 1140w\" sizes=\"(max-width: 600px) 100vw, 600px\" \/><\/p>\n<h2>Cum se efectueaz\u0103 diagnosticul pentru piciorul c\u0103zut?<\/h2>\n<p>La examenul clinic medicul specialist neurolog observ\u0103 imposibilitatea ridic\u0103rii labei piciorului, precum \u0219i dificult\u0103\u021bi \u00een orientarea c\u0103tre exterior a labei piciorului.<\/p>\n<p>Diagnosticul diferen\u021bial care se impune este cu\u00a0 lombosciatica, afectarea plexului lombo-sacrat \u0219i leziuni ale nervului sciatic.<\/p>\n<p>Fiecare din aceste afec\u021biuni prezint\u0103 semne clinice particulare ce pot fi identificate \u00een cadrul unui examen clinic minu\u021bios. \u00cens\u0103 diagnosticul de certitudine este stabilit printr-o explorare specific\u0103 \u2013 <a href=\"https:\/\/roneuro.ro\/blog\/cand-se-recomanda-un-control-enmg\/\">electroneuromiografia (ENMG)<\/a>.<\/p>\n<p style=\"text-align: left;\">Pentru mai multe informa\u021bii despre ENMG, accesa\u021bi interviul video cu specialistul nostru dr. Maria Balea:<\/p>\n<p style=\"text-align: center;\"><iframe title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/-HleXKdJtcY?si=ytHYMkLiC77Howbe\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>La Institutul RoNeuro, doctorii no\u0219trii pot detecta poten\u021biale de ac\u021biune motorii \u0219i senzitive pe diferi\u021bi nervi periferici, m\u0103sur\u00e2nd vitezele de conducere nervoas\u0103, iar \u00een a doua parte a examin\u0103rii, prin plasarea unui electrod ac \u00een mu\u0219chii deservi\u021bi de ace\u0219ti nervi, pot preciza gradul de suferin\u021b\u0103 a fibrelor nervoase comprimate.<\/p>\n<p style=\"text-align: left;\">Dup\u0103 confirmarea diagnosticului \u0219i prescrierea medica\u021biei, pacientul va fi orientat c\u0103tre tehnici de<a href=\"https:\/\/www.roneuro.ro\/specialitati\/kinetoterapie.html\"> kinetoterapie<\/a> \u0219i stimulare magnetic\u0103 periferic\u0103 repetitiv\u0103 (rPMS).<\/p>\n<p style=\"text-align: center;\"><iframe title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/OKN0iC9bop4?si=5Ulrhzm-bMiko0c5\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<h2>Resurse \u0219i suport pentru pacien\u021bi<\/h2>\n<p>Dac\u0103 prezenta\u021bi simptome de picior c\u0103zut programa\u021bi-v\u0103 <span style=\"font-weight: 400;\">acum la un specialist neurolog <\/span><span style=\"font-weight: 400;\">contact\u00e2nd recep\u021bia <strong>Institutului RoNeuro<\/strong> la num\u0103rul de telefon<\/span><b> <a href=\"tel:+40374462222\">0374 46 2222<\/a><\/b><span style=\"font-weight: 400;\">, <strong>luni \u0219i mar\u021bi \u00eentre orele 08:00 &#8211; 19:00<\/strong>, iar de <strong>miercuri p\u00e2n\u0103 vineri \u00eentre orele 08:00 &#8211; 18:00<\/strong>.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">La momentul program\u0103rii, pute\u021bi opta \u0219i pentru consulta\u021bie neurologic\u0103 gratuit\u0103, decontat\u0103 prin Casa Na\u021bional\u0103 de Asigur\u0103ri de S\u0103n\u0103tate.\u00a0<\/span><\/p>\n<p style=\"text-align: center;\"><a style=\"background-color: #6852ed; color: white; text-decoration: none; border: none; padding: 10px 20px; cursor: pointer; display: inline-block;\" href=\"https:\/\/www.roneuro.ro\/progamari.html\">Program\u0103ri online neurologie<\/a><\/p>\n<p><span style=\"font-weight: 400;\">Locui\u021bi \u00eentr-o zon\u0103 izolat\u0103 sau nu v\u0103 pute\u021bi deplasa la clinic\u0103? Institutul RoNeuro ofer\u0103 \u0219i op\u021biunea de <\/span><b><a href=\"https:\/\/www.roneuro.ro\/telemedicina.html\" target=\"_blank\" rel=\"noopener\">telemedicin\u0103<\/a>.<\/b><\/p>\n<h2>C\u00e2t de comun este piciorul c\u0103zut?<\/h2>\n<p>Inciden\u021ba neuropatiei fibulare este de aproximativ 19 la 100.000 de persoane, fiind mai frecvent\u0103 la b\u0103rba\u021bi dec\u00e2t la femei. Nou\u0103zeci la sut\u0103 din cazuri sunt unilaterale. P\u0103r\u021bile dreapt\u0103 \u0219i st\u00e2ng\u0103 sunt afectate \u00een mod egal [2].<\/p>\n<p>Inciden\u021ba anual\u0103 la nivel mondial este estimat\u0103 la 1,54 la 100.000. Poate afecta persoanele la orice v\u00e2rst\u0103, dar este mai frecvent\u0103 \u00eentre 50 \u0219i 75 de ani [2].<\/p>\n<h2>Care sunt metodele de tratament pentru piciorul c\u0103zut?<\/h2>\n<h3>Kinetoterapie<\/h3>\n<p>Metodele de tratament sunt cel mai adesea sub forma kinetoterapiei prin:<\/p>\n<ul>\n<li>Consolidare;<\/li>\n<li>\u00centindere;<\/li>\n<li>Exerci\u021bii de echilibru.<\/li>\n<\/ul>\n<h3>Dispozitivele asistive<\/h3>\n<p>Mai mult, se pot folosi dispozitivele asistive, precum \u0219i aparate ortopedice \u0219i orteze. Ortezele pentru glezn\u0103 \u0219i picior sunt dispozitive care men\u021bine glezna \u0219i piciorul \u00een pozi\u021bie pentru a ajuta piciorul s\u0103 se ridice de la sol. De obicei, este prescris\u0103 la \u00eenceputul reabilit\u0103rii. Aceasta poate \u00eembun\u0103t\u0103\u021bi viteza de mers, echilibrul, postura, siguran\u021ba \u0219i \u00eencrederea [1].<\/p>\n<h3>Interven\u021bie chirurgical\u0103<\/h3>\n<p>Rareori este nevoie \u0219i de interven\u021bie chirurgical\u0103 pentru a reduce presiunea asupra nervului sau pentru a-l repara. Poate fi nevoie \u0219i de opera\u021bie de fuzionare a oaselor gleznei sau ale piciorului sau transferul tendonului de la piciorul s\u0103n\u0103tos la mu\u0219chiul afectat.<\/p>\n<p>\u00cen cazul \u00een care c\u0103derea piciorului este temporar\u0103, generat\u0103 de inflama\u021bia nervului sau leziuni minore cauzate de compresie, poate s\u0103 nu fie necesar\u0103 interven\u021bie medical\u0103. Alteori, aceasta se rezolv\u0103 cu tratament. Totu\u0219i, \u00een cazul afec\u021biunilor cronice subiacente, precum cele neurodegenerative, aceasta poate fi permanent\u0103 [3].<\/p>\n<p>Deoarece cauzele sunt multiple, este necesar un control medical.<\/p>\n<p>Pentru a gestiona piciorul c\u0103zut este recomandat s\u0103:<\/p>\n<ul>\n<li>Folosi\u021bi un ajutor pentru mers, precum un baston;<\/li>\n<li>V\u0103 asigura\u021bi c\u0103 reduce\u021bi riscul de \u00eempiedicare \u00een cas\u0103 prin \u00eendep\u0103rtarea lucrurilor precum covoarele libere;<\/li>\n<li>Utiliza\u021bi balustrade atunci c\u00e2nd urca\u021bi sau cobor\u00e2\u021bi sc\u0103rile.<\/li>\n<\/ul>\n<h2>Concluzii<\/h2>\n<p>De\u0219i piciorul c\u0103zut nu apare la fel de des ca alte afec\u021biuni, acesta afecteaz\u0103 mersul \u0219i echilibrul, f\u0103c\u00e2nd dificil\u0103 deplasarea \u0219i \u00eengreun\u00e2nd vie\u021bile celor afecta\u021bi. Av\u00e2nd o multitudine de cauze posibile, este necesar ca persoanele ce prezint\u0103 simptome s\u0103 fie evaluate de un specialist medical, pentru a putea determina cel mai corect parcurs al tratamentului.<\/p>\n<h2>Referin\u021be<\/h2>\n<ol>\n<li>(N.d.). Stroke.org. Retrieved January 19, 2025, from https:\/\/www.stroke.org\/en\/about-stroke\/effects-of-stroke\/physical-effects\/foot-drop<\/li>\n<li>Nori SL, Stretanski MF. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK554393\/\" target=\"_blank\" rel=\"noopener\">Foot Drop<\/a>. [Updated 2024 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.<\/li>\n<li><a href=\"https:\/\/www.ninds.nih.gov\/health-information\/disorders\/foot-drop-syndrome\" target=\"_blank\" rel=\"noopener\"><em>Foot drop syndrome<\/em>.<\/a> (n.d.). National Institute of Neurological Disorders and Stroke. Retrieved January 19, 2025.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Ce este piciorul c\u0103zut? Piciorul c\u0103zut reprezint\u0103 un aspect destul de des \u00eent\u00e2lnit \u00een practica clinic\u0103, av\u00e2nd la baz\u0103 o afec\u021biune neurologic\u0103, precum un accident vascular cerebral. Acesta se observ\u0103 atunci c\u00e2nd persoanele nu pot ridica partea din fa\u021b\u0103 a piciorului din cauza sl\u0103biciunii sau paraliziei mu\u0219chilor necesari pentru aceast\u0103 ac\u021biuni. Adesea, pacien\u021bii t\u00e2r\u0103sc piciorul [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":541,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jnews-multi-image_gallery":[],"jnews_single_post":{"source_name":"","source_url":"","via_name":"","via_url":"","override_template":"0","override":[{"template":"1","single_blog_custom":"","parallax":"1","fullscreen":"1","layout":"right-sidebar","sidebar":"default-sidebar","second_sidebar":"default-sidebar","sticky_sidebar":"1","share_position":"top","share_float_style":"share-monocrhome","show_share_counter":"1","show_view_counter":"1","show_featured":"1","show_post_meta":"1","show_post_author":"1","show_post_author_image":"1","show_post_date":"1","post_date_format":"default","post_date_format_custom":"Y\/m\/d","show_post_category":"1","show_post_reading_time":"0","post_reading_time_wpm":"300","show_zoom_button":"0","zoom_button_out_step":"2","zoom_button_in_step":"3","show_post_tag":"1","show_prev_next_post":"1","show_popup_post":"1","number_popup_post":"1","show_author_box":"0","show_post_related":"0","show_inline_post_related":"0","post_calculate_word_method":"str_word_count"}],"override_image_size":"0","image_override":[{"single_post_thumbnail_size":"crop-500","single_post_gallery_size":"crop-500"}],"trending_post":"0","trending_post_position":"meta","trending_post_label":"Trending","sponsored_post":"0","sponsored_post_label":"Sponsored by","sponsored_post_name":"","sponsored_post_url":"","sponsored_post_logo_enable":"0","sponsored_post_logo":"","sponsored_post_desc":"","disable_ad":"0","format":"standard","subtitle":""},"jnews_primary_category":{"id":"","hide":""},"jnews_override_counter":{"override_view_counter":"0","view_counter_number":"0","override_share_counter":"0","share_counter_number":"0","override_like_counter":"0","like_counter_number":"0","override_dislike_counter":"0","dislike_counter_number":"0"},"footnotes":""},"categories":[6],"tags":[],"class_list":["post-148","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-neurologie"],"_links":{"self":[{"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/posts\/148","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/comments?post=148"}],"version-history":[{"count":4,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/posts\/148\/revisions"}],"predecessor-version":[{"id":1680,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/posts\/148\/revisions\/1680"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/media\/541"}],"wp:attachment":[{"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/media?parent=148"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/categories?post=148"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/roneuro.ro\/blog\/wp-json\/wp\/v2\/tags?post=148"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}