Physiotherapy Management of a Patient with Drop Foot due to Herpes Zoster Infection During the
Covid 19 Pandemic Period: A Case Report
Aim: Herpes zoster (HZ) is a common viral disease that typically presents a characteristic painful skin
lesion. However, motor neuropathy is an infrequent complication of HZ infection. Current literature
provides limited information about its evaluation and management. Therefore, here I report the
physiotherapy practise in a case of a HZ patient who presented with sciatica and foot drop. Methods:
I describe a 61-year-old man who developed a severe right common peroneal nerve
mononeuropathy after a rash consistent with HZ in the territory of distribution region of this nerve.
The patient stated that he postponed going to the hospital due to the anxiety of Covid-19
contamination during the pandemic period. After nerve decompression surgery, patient was treated
with physiotherapy program in addition to the medical treatment and ankle foot orthesis (AFO).
Physiotherapy program consisted of transcutaneous electrical nerve stimulation; neuromuscular
electric stimulation; hotpack; range of motion, stretching and strengthening exercises; walking
training and AFO adaptation. Before and after the physiotherapy program pain was evaluated with
Visual Analogue Scale (VAS), muscle weakness with manuel muscle test, functional impairment with
Lower Extremity Functional Scale (LEFS) and quality of life with Short Form-36 (SF-36). Results: At the
end of the physiotherapy program that lasted for 5 months, pain intensity decreased by 1/10 from
9/10; dorsiflexor muscle strength reached 3-/5 from 1/5; evertor muscle strength reached 3-/5 from
2/5, plantar flexor muscle strength reached 5/5 from 4/5 in the affacted side; function improved by
43/80 from 19/80; quality of life improved in each subscore. Conclusions: Applied physiotherapy
program after nerve decompression surgery improved pain, muscle strength, function and quality of
life in this case. To the best of my knowledge, this is a first-time report on the physiotherapy
management of drop foot associated with HZ. Keywords: Drop foot; herpes zoster; pain; peroneal
nerve; physiotherapy.