Evaluation of Tibial Nerve Selective Neurotomy Compared to Botulinum Toxin Injections for Spastic Foot Treatment in Post-stroke Patients According to a Goal-centered Approach

Inclusion Criteria

• •Adult patients (older than 18 years)
• •Man and woman
• •Hemiparesis secondary to stroke (delay from stroke \> 1 year)
• •Foot with equinovarus with or without toe claw due to spasticity of at least the triceps surae and /or one of the following muscles: tibialis posterior, flexor digitorum and hallucis longus muscles.
• •Spasticity confirmed with no isolated tendon shortening diagnosed using tibialis nerve block under local anesthesia with at least a 5 degrees gain in passive or active ankle dorsal flexion.
• •Covered by National French insurance
• •Able to understand French and the purpose of the study
• •Informed consent signed by the patient or consent obtained from a relative or trusted person of the patient